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目的了解文化程度与北京社区T2DM患者心血管病危险因素达标率和微血管并发症患病率的关系。方法纳入北京27个社区2213例T2DM患者,分为初中及以下组1312例和高中及以上组901例。比较两组HbA_1c、LDL-C、BP达标率和糖尿病微血管并发症患病率。结果与初中及以下组比较,高中及以上组HbA_1c(51.9%vs 46.5%)、BP达标率(39.1%vs 28.3%)更高(P<0.05或P<0.01),HbA_1c+LDL-C+BP综合达标率也高于初中及以下组(9.8%vs 6.0%,P<0.01),DPN(10.2%vs 18.8%)、DR(21.6%vs 27.7%)和DN(26.6%vs 32.5%)患病率均较初中及以下组低(P<0.01)。校正年龄、性别、吸烟、教育、医保、LDL-C等因素后,SBP不达标者DPN、DR、DN患病率高于SBP达标者[OR(95%CI):1.017(1.007~1.027)、1.011(1.002~1.019)、1.019(1.01~1.027)];HbA_1c不达标者DR、DN患病率高于HbA_1c达标者[OR(95%CI):1.141(1.074 1.213)、1.195(1.127~1.268)]。结论北京社区T2DM患者中,高中及以上组心血管病危险因素控制效果更好,糖尿病微血管并发症患病率更低。
Objective To investigate the relationship between educational level and the compliance rate of cardiovascular risk factors and the prevalence of microvascular complications in T2DM patients in Beijing community. METHODS: Totally 2213 T2DM patients from 27 communities in Beijing were enrolled. There were 1312 T2DM patients of junior high school and below and 901 patients of high school and above. The prevalences of HbA 1c, LDL-C, BP and the incidence of diabetic microvascular complications in both groups were compared. Results HbA 1c (51.9% vs 46.5%) and BP compliance (39.1% vs 28.3%) were significantly higher in high school and above (P <0.05 or P <0.01) The overall compliance rate was also higher than those in junior high school and below (9.8% vs 6.0%, P <0.01), DPN (10.2% vs 18.8%), DR (21.6% vs 27.7%) and DN (26.6% vs 32.5% The rates were lower than those in junior high school and lower group (P <0.01). The prevalences of DPN, DR and DN in those who failed to meet the criteria for SBP were higher than those who achieved SBP [OR (95% CI: 1.017 (1.007-1.027,]] after correcting for age, gender, smoking, education, health insurance and LDL- 1.011 (1.01-1.027), 1.019 (1.01-1.227)]. The prevalences of DR and DN in non-compliance of HbA 1c were higher than those of HbA 1c compliance (OR 95% CI: 1.141 1.074 1.213, 1.195 1.127-1.268) ]. Conclusions Among T2DM patients in Beijing community, the risk factors for cardiovascular diseases in high school and above are better controlled and the prevalence of diabetic microvascular complications is lower.