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目的研究常熟市男性2型糖尿病(T2DM)患者吸烟对血糖水平的影响。方法选取常熟市目前已纳入国家基本公共卫生服务的4 157例男性T2DM患者,按吸烟情况分为大量吸烟组、少量吸烟组、戒烟组和不吸烟组,通过问卷调查收集患者的一般人口学资料、生活方式和疾病信息;测量身高、体重、腰围和臀围等,计算体质指数(BMI)和腰臀比(WHR);实验室检测空腹血糖(FPG)和糖化血红蛋白(Hb A1c)。比较各组患者一般情况和血糖水平的差异,采用协方差分析校正可能的混杂因素影响,采用多元线性回归分析和偏相关分析了解吸烟与血糖水平的相关性及影响程度。结果大量吸烟组与少量吸烟组、戒烟组、不吸烟组相比,FPG均偏高(均P<0.05),校正可能的混杂因素后,差异均无统计学意义(均P>0.05);大量、少量吸烟组与戒烟组、不吸烟组相比,Hb A1c均偏高(均P<0.05),校正可能的混杂因素后,差异仍有统计学意义(均P<0.05);每日吸烟支数是Hb A1c的影响因素(β=0.07,P<0.05)。开始吸烟年龄与FPG、Hb A1c不存在相关性(均P>0.05);每日吸烟支数与Hb A1c存在正相关关系(r=0.06,P<0.05),但与FPG不存在相关性(P>0.05)。结论吸烟对常熟市男性T2DM患者血糖水平有一定程度的影响,需加强健康教育,进一步降低男性居民吸烟率。
Objective To investigate the effect of smoking on blood glucose in male patients with type 2 diabetes mellitus (T2DM) in Changshu city. Methods A total of 4 157 male patients with T2DM who were included in the national basic public health services were selected and divided into a large number of smoking groups, a few smoking groups, a smoking cessation group and a non-smoking group according to their smoking status. The general demographic data of patients were collected through questionnaire survey , Lifestyle and disease information. Body height, weight, waist circumference and hip circumference were measured. Body mass index (BMI) and waist-hip ratio (WHR) were calculated. Fasting plasma glucose (FPG) and HbA1c were detected in the laboratory. Covariance analysis was used to investigate the possible influence of confounding factors. Multivariate linear regression analysis and partial correlation analysis were used to investigate the correlation between smoking and blood glucose levels and the degree of influence. Results Compared with those in small amount of smoking group, smoking cessation group and non-smoking group, FPG were higher in large number of smoking group (all P <0.05), and no significant difference was found after adjusting for possible confounding factors (all P> 0.05) (P <0.05). There were still significant differences in Hb A1c between the small number of smoking groups and the smoking cessation group and the non-smoking group (all P <0.05). After adjusting for possible confounding factors, the differences were still statistically significant The number is the influencing factor of Hb A1c (β = 0.07, P <0.05). There was no significant correlation between age at onset of smoking and FPG and Hb A1c (all P> 0.05). There was a positive correlation between daily smoking counts and Hb A1c (r = 0.06, P <0.05), but no correlation with FPG > 0.05). Conclusion Smoking has a certain degree of influence on blood glucose level in male patients with T2DM in Changshu City. It is necessary to strengthen health education and further reduce the smoking rate of male residents.