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中文摘要: 摘 要:目的:分析社区老年人群糖化血红蛋白 (hemoglobin A one c,HbA1c) 的控制情况及相关性。方法:选取 2021
年和 2023 年在上海市嘉定区马陆镇社区卫生服务中心参加健康体检的≥60 岁老年人,其中 2021 年 10 922 人,2023 年 16 496
人,分析 HbA1c 的影响因素。结果:2021 年不同体质指数 (BMI)、总胆固醇 (TC)、低密度脂蛋白 (LDL)、肌酐 (Cr)、尿
酸体检老年人 HbA1c 控制率差异均有统计学意义 ( χ 2 值分别为 58.648、59.429、42.384、14.670、4.822,P<0.05);2023 年
不同 BMI、血清谷草转氨酶 (AST)、TC、LDL、Cr、高密度脂蛋白 (HDL)、总胆红素 (TBIL) 体检老年人 HbA1c 控制率差
异均有统计学意义 ( χ 2 值分别为 21.836、4.601、1 923.362、2 936.174、63.548、6.280、6.837,P<0.05)。Spearman 相关性分
析结果显示,2021 年老年人 HbA1c 与 BMI、TC、LDL、Cr 均呈正相关 (r 值分别为 0.071、0.074、0.062、0.037,P<0.05),
与尿酸、饮食习惯均呈负相关 (r 值分别为-0.021、-0.020,P<0.05);2023 年老年人 HbA1c 与 TC、LDL、Cr、HDL 均呈正
相关 (r 值分别为 0.341、0.422、0.062、0.020,P<0.05),与 BMI、AST 均呈负相关 (r 值分别为-0.027、-0.017,P<0.05)。
logistic 回归分析结果显示,2021 年尿酸异常 (OR=0.820) 是 HbA1c 控制的保护因素,BMI 为超重 (OR=1.195)、TC 异常
(OR=1.352)、Cr 异常 (OR=1.530) 是 HbA1c 控制的危险因素;2023 年 BMI 为超重 (OR=0.869) 是血糖控制的保护因素,
TC 异常 (OR=2.728)、LDL 异常 (OR=14.109)、Cr 异常 (OR=1.475)、TBIL 降低 (OR=4.175) 是血糖控制的危险因素。
结论:社区老年人糖化血红蛋白控制情况较好,BMI、TC、LDL、Cr、尿酸和 TBIL 对控制血糖具有重要的指导意义,在老年
人健康管理中应特别关注,采取相应的措施提高 HbA1c 控制率。
Abstract:Abstract: OBJECTIVE To analyze the control status and correlation of HbA1c among the elderly population in Community.
METHODS The elderly over 60 years old who participated in physical examination in Malu Community Health Service Center in 2021 and
2023 were selected as the research objects, and the correlation of HbA1c influencing factors was analyzed by T-test, χ 2 test, Spearman
correlation and multi-factor logistics. RESULTS The difference in control rates among different BMI groups, TC groups, LDL groups, Cr
groups, and uric acid groups in 2021 is statistically significant ( χ 2 =58.648, 59.429, 42.384, 14.670, 4.822, P<0.05). There was a
statistically significant difference in control rates among different BMI groups, AST groups, TC groups, LDL groups, Cr groups, HDL groups,
and TBIL groups in 2023 (χ 2 =21.836, 4.601, 1923.362, 2936.174, 63.548, 6.280, 6.837, P<0.05). Spearman correlation analysis showed
that in 2021, HbA1c was positively correlated with BMI, TC, LDL, and Cr (r=0.071, 0.074, 0.062, 0.037, P<0.05), and negatively
correlated with uric acid and dietary habits (r=-0.021, -0.020, P<0.05). In 2023, HbA1c was positively correlated with TC, LDL, Cr and
HDL (r=0.341, 0.422, 0.062, 0.020, P<0.05), and negatively correlated with BMI and AST (r=-0.027, -0.017, P<0.05). The results of
multi-factor logistics analysis showed that in 2021, abnormal uric acid (OR=0.820) was a protective factor for HbA1c control, BMI was
overweight (OR=1.195), TC was abnormal (OR=1.352) and abnormal Cr (OR=1.530) were risk factors for HbA1c control. In 2023,
overweight BMI (OR=0.869) was a protective factor for HbA1c control, abnormal TC (OR=2.728), abnormal LDL (OR=14.109),
abnormal Cr (OR=1.475), and decreased TBIL (OR=4.175) were risk factors for HbA1c control. CONCLUSION Elderly people in the
community have better control over HbA1c, and BMI, TC, LDL, Cr, uric acid and TBIL have important guiding significance for the control
of blood sugar. Special attention should be paid to the health management of the elderly, and corresponding measures should be taken to
improve the control rate of HbA1c.
文章编号：3202410008 中图分类号：R587.1 文献标志码：
基金项目:
| 作者 | 单位 |
| 王钰涓,戈园园,倪海峰 |
| Author Name | Affiliation |
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