2型糖尿病患者饮食自我管理与糖化血红蛋白控制情况的关系研究
目的:探讨2型糖尿病（T2DM）患者饮食自我管理的影响因素及其与糖化血红蛋白（HbA 1c）控制情况的关系。 方法:选择2021年5月11至20日在北京市朝阳区4家医院就诊的275例T2DM患者作为研究对象，采用微信问卷及面对面调查收集一般资料及疾病相关资料，利用《2型糖尿病患者饮食行为依从性测评量表》评估饮食自我管理情况（包括糖类脂肪类遵医行为、果蔬类遵医行为、烹饪方式进餐习惯、油盐类遵医行为、饮食自我监管方面5个维度及饮食依从性总评分）。体重分类按照世界卫生组织提出的中国成人体重指数（BMI）分类标准。对275例T2DM患者建立受试者工作特征（ROC）曲线检验患者饮食依从性总评分对HbA...
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| Published in | 中华糖尿病杂志 Vol. 13; no. 12; pp. 1123 - 1129 |
|---|---|
| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | Chinese |
| Published |
应急总医院内分泌科，北京 100028%华北理工大学研究生院，唐山 063000
01.12.2021
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 1674-5809 |
| DOI | 10.3760/cma.j.cn115791-20210606-00314 |
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| Abstract | 目的:探讨2型糖尿病（T2DM）患者饮食自我管理的影响因素及其与糖化血红蛋白（HbA
1c）控制情况的关系。
方法:选择2021年5月11至20日在北京市朝阳区4家医院就诊的275例T2DM患者作为研究对象，采用微信问卷及面对面调查收集一般资料及疾病相关资料，利用《2型糖尿病患者饮食行为依从性测评量表》评估饮食自我管理情况（包括糖类脂肪类遵医行为、果蔬类遵医行为、烹饪方式进餐习惯、油盐类遵医行为、饮食自我监管方面5个维度及饮食依从性总评分）。体重分类按照世界卫生组织提出的中国成人体重指数（BMI）分类标准。对275例T2DM患者建立受试者工作特征（ROC）曲线检验患者饮食依从性总评分对HbA
1c达标（<7%）情况的诊断切点，饮食依从性评分80.5分约登指数最大（0.240），依据此分数作为切点将患者分为遵从饮食控制组（98例）和不遵从饮食控制组（177例）。204例患者近3个月检测了HbA
1c，根据HbA
1c水平分为HbA
1c达标组（HbA
1c<7%，69例）和HbA
1c不达标组（HbA
1c≥7%，135例）。两组间比较采用
t检验、χ2检验和Fisher确切概率法。采用多因素logistic回归及多元线性回归分析法分析患者饮食自我管理及HbA
1c达标的影响因素。
结果:275例患者中超重115例（41.8%）、肥胖46例（16.7%）。与不遵从饮食控制组相比，遵从饮食控制组女性更多、超重及肥胖比例更低（均
P<0.01）。多因素logistic回归分析结果显示，女性（OR=2.074，95%CI 1.195~3.600，
P=0.01）与BMI<24 kg/m
2（OR=2.317，95
%CI 1.349~3.978，
P=0.002）是遵从饮食控制的影响因素。将患者按照性别及BMI分层后比较各维度饮食依从性评分，结果显示，BMI<24 kg/m
2的患者饮食依从性总评分及各维度评分均高于BMI≥24 kg/m
2的患者（
P<0.05），女性在除饮食自我监管方面的其他4个维度及饮食依从性总评分方面均优于男性（均
P<0.05）。HbA
1c达标组饮食依从性总评分高于HbA
1c不达标组［分别为（82.0±12.4）和（75.6±12.9）分，
P=0.001］，5个饮食依从性维度中除烹饪及进餐习惯外，其他4个维度评分，HbA
1c达标组均高于HbA
1c不达标组（均
P<0.05）。多因素l |
|---|---|
| AbstractList | 目的:探讨2型糖尿病（T2DM）患者饮食自我管理的影响因素及其与糖化血红蛋白（HbA
1c）控制情况的关系。
方法:选择2021年5月11至20日在北京市朝阳区4家医院就诊的275例T2DM患者作为研究对象，采用微信问卷及面对面调查收集一般资料及疾病相关资料，利用《2型糖尿病患者饮食行为依从性测评量表》评估饮食自我管理情况（包括糖类脂肪类遵医行为、果蔬类遵医行为、烹饪方式进餐习惯、油盐类遵医行为、饮食自我监管方面5个维度及饮食依从性总评分）。体重分类按照世界卫生组织提出的中国成人体重指数（BMI）分类标准。对275例T2DM患者建立受试者工作特征（ROC）曲线检验患者饮食依从性总评分对HbA
1c达标（<7%）情况的诊断切点，饮食依从性评分80.5分约登指数最大（0.240），依据此分数作为切点将患者分为遵从饮食控制组（98例）和不遵从饮食控制组（177例）。204例患者近3个月检测了HbA
1c，根据HbA
1c水平分为HbA
1c达标组（HbA
1c<7%，69例）和HbA
1c不达标组（HbA
1c≥7%，135例）。两组间比较采用
t检验、χ2检验和Fisher确切概率法。采用多因素logistic回归及多元线性回归分析法分析患者饮食自我管理及HbA
1c达标的影响因素。
结果:275例患者中超重115例（41.8%）、肥胖46例（16.7%）。与不遵从饮食控制组相比，遵从饮食控制组女性更多、超重及肥胖比例更低（均
P<0.01）。多因素logistic回归分析结果显示，女性（OR=2.074，95%CI 1.195~3.600，
P=0.01）与BMI<24 kg/m
2（OR=2.317，95
%CI 1.349~3.978，
P=0.002）是遵从饮食控制的影响因素。将患者按照性别及BMI分层后比较各维度饮食依从性评分，结果显示，BMI<24 kg/m
2的患者饮食依从性总评分及各维度评分均高于BMI≥24 kg/m
2的患者（
P<0.05），女性在除饮食自我监管方面的其他4个维度及饮食依从性总评分方面均优于男性（均
P<0.05）。HbA
1c达标组饮食依从性总评分高于HbA
1c不达标组［分别为（82.0±12.4）和（75.6±12.9）分，
P=0.001］，5个饮食依从性维度中除烹饪及进餐习惯外，其他4个维度评分，HbA
1c达标组均高于HbA
1c不达标组（均
P<0.05）。多因素l |
| Abstract_FL | Objective:To investigate the influencing factors of diet self-management and its relationship with glycated hemoglobin A
1c (HbA
1c) control in patients with type 2 diabetes mellitus (T2DM).
Methods:A total of 275 patients with T2DM in four hospitals in Chaoyang District of Beijing were investigated by WeChat questionnaire and face-to-face questionnaire, and the dietary behavior compliance scale for patients with T2DM (including total score and scores of five dimensions: diet self-regulation, sugar and fat compliance behavior, oil and salt compliance behavior, fruit and vegetable compliance behavior, cooking and eating habits) was used to evaluate their dietary self-management. The weight classification was based on the Chinese adult body mass index (BMI) proposed by the World Health Organization classification. The receiver operating characteristic (ROC) curve was established for 275 subjects to test the diagnostic cut-off point between the total score of patients′ dietary compliance and HbA
1c. The cut-off score of dietary compliance was 80.5, with the highest Jordan index (0.240). The patients were divided into two groups: compliance with diet management group (98 cases) and non-compliance with diet management group (177 cases). Two hundred and four patients provided the latest HbA
1c results in recent 3 months, 69 cases (33.8%) met the standard (HbA
1c<7% group) and 135 cases (66.2%) failed to meet the standard (HbA
1c≥7% group). The measurement data in line with normal distribution were analyzed by
t-test between the two groups. The comparison of classified data was analyzed by Chi square test or Fisher exact probability method. Multivariate logistic regression and multiple linear correlation analysis were used to analyze the influencing factors affecting patients′ dietary self-management and HbA
1c compliance.
Results:Among 275 subjects, 115 cases (41.8%) were overweight and 46 cases (16.7%) were obese. There were more women and lower rates of overweight and obesity in the HbA
1c<7% group than those in the HbA
1c≥7% group (all
P<0.01). Women and the patients with BMI<24 kg/m
2 had higher percentage of compliance with diet management (
P<0.01). Multivariate logistic regression analysis showed that women and the patients with BMI<24 kg/m
2 were correlated with better dietary compliance. Patients were stratified according to gender and BMI, and the scores of dietary compliance in five dimensions were compared. The results showed that patients with BMI<24 kg/m
2 had higher scores in all aspects and total dietary compliance than those with BMI≥24 kg/m
2 (
P<0.05). Females had higher scores than males in other four dimensions of diet compliance behaviors (all
P<0.05) except for the score of dietary self-regulation (
P>0.05). The total score of dietary compliance of the HbA
1c<7% group was higher than that of the HbA
1c≥7% group [(82.0±12.4) vs. (75.6±12.9) points,
P=0.001]. Among the five dimensions of dietary compliance, except cooking and eating habits (
P>0.05), the scores of other four dimensions were all higher than those of the HbA
1c≥7% group (all
P<0.05). Multivariate analysis showed that BMI<24 kg/m
2 (OR=3.007, 95%CI 1.525-5.928) and self-management of diet (OR=3.003, 95%CI 1.305-6.912) were related to HbA
1c<7%. The results of multiple linear regression showed that there was a negative correlation between education level (β=-0.175,
P=0.022), dietary compliance score (β=-0.162,
P=0.026) and HbA
1c level.
Conclusions:The percentage of overweight and obesity of the participants is high, and the percentage of HbA
1c <7% is low. Female and patients with BMI<24 kg/m
2 are the factors of good dietary self-management compliance. BMI<24 kg/m
2 and self-management of diet are the factors of HbA
1c<7%. Patients with higher education level and dietary compliance score have lower HbA
1c level. |
| Author | 王凯亮 孙焱 杨倩倩 李洪梅 张焱 王冰 韩旸 朱海清 |
| AuthorAffiliation | 应急总医院内分泌科，北京 100028%华北理工大学研究生院，唐山 063000 |
| AuthorAffiliation_xml | – name: 应急总医院内分泌科，北京 100028%华北理工大学研究生院，唐山 063000 |
| Author_FL | Li Hongmei Zhu Haiqing Zhang Yan Sun Yan Yang Qianqian Wang Bing Wang Kailiang Han Yang |
| Author_FL_xml | – sequence: 1 fullname: Zhu Haiqing – sequence: 2 fullname: Yang Qianqian – sequence: 3 fullname: Wang Bing – sequence: 4 fullname: Wang Kailiang – sequence: 5 fullname: Han Yang – sequence: 6 fullname: Sun Yan – sequence: 7 fullname: Zhang Yan – sequence: 8 fullname: Li Hongmei |
| Author_xml | – sequence: 1 fullname: 朱海清 – sequence: 2 fullname: 杨倩倩 – sequence: 3 fullname: 王冰 – sequence: 4 fullname: 王凯亮 – sequence: 5 fullname: 韩旸 – sequence: 6 fullname: 孙焱 – sequence: 7 fullname: 张焱 – sequence: 8 fullname: 李洪梅 |
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| Keywords | 饮食依从性 Hemoglobin A, glycosylated 糖尿病，2型 血红蛋白A，糖基化 Diabetes mellitus, type 2 Dietary compliance |
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| PublicationTitle | 中华糖尿病杂志 |
| PublicationTitle_FL | Chinese Journal of Diabetes Mellitus |
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| Snippet | 目的:探讨2型糖尿病（T2DM）患者饮食自我管理的影响因素及其与糖化血红蛋白（HbA
1c）控制情况的关系。
方法:选择2021年5月11至20日在北京市朝阳区4家医院就诊的275例T2DM... |
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| Title | 2型糖尿病患者饮食自我管理与糖化血红蛋白控制情况的关系研究 |
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