老年初诊2型糖尿病患者生活方式干预依从性的影响因素
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(中南大学湘雅医学院附属海口医院内分泌代谢科,海口 570208)

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R587.1

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海南省卫生健康行业科研项目(20A200197)


Influencing factors of lifestyle intervention compliance in elderly patients with newly-diagnosed diabetes mellitus
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(Department of Endocrinology and Metabolism, Haikou Hospital Affiliated to Xiangya School of Medicine, Central South University, Haikou 570208, China)

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    摘要:

    目的 分析老年初诊2型糖尿病(T2DM)患者生活方式干预依从性的影响因素。方法 回顾性分析2022年1月至6月中南大学湘雅医学院附属海口医院收治的86例初诊老年T2DM患者的临床资料,6个月后复诊时评估其生活方式干预的依从性。根据依从性将患者分为依从性不良组(41例)与依从性良好组(45例),比较两组患者的人口学特征、稳态模型胰岛素抵抗指数(HOMA-IR)及稳态模型胰岛β细胞功能指数(HOMA-β)情况。采用SPSS 23.0统计软件进行数据分析。根据数据类型,分别采用t检验、χ2检验或连续校正χ2检验进行组间比较。采用二元logistic回归分析初诊老年T2DM患者生活方式干预依从性的影响因素。结果 两组患者复诊时HOMA-IR均较初诊时降低,且依从性良好组复诊HOMA-IR低于依从性不良组;HOMA-β均较初诊时升高,且依从性良好组复诊HOMA-β高于依从性不良组,差异均有统计学意义(P<0.05)。二元logistic回归分析显示,离异/丧偶(OR=2.633,95%CI 1.513~4.581;P<0.05)、独居(OR=2.326,95%CI 1.218~4.442;P<0.05)及糖尿病家族史(OR=0.655,95%CI 0.197~0.983;P<0.05)均为初诊老年T2DM患者生活方式干预依从性不良的影响因素。结论 初诊老年T2DM患者中,生活方式干预依从性不良者胰岛β细胞功能及胰岛素抵抗控制效果较差,且离异/丧偶及独居者更易出现生活方式干预依从性不良,有糖尿病家族史者常具有良好依从性。

    Abstract:

    Objective To analyze the factors influencing compliance with lifestyle intervention in the elderly patients with newly-diagnosed type 2 diabetes mellitus (T2DM). Methods A retrospective analysis was made of the clinical data of 86 elderly patients with newly-diagnosed T2DM admitted to Haikou Hospital Affiliated to Xiangya School of Medicine, Central South University, from January to June 2022. Their compliance with lifestyle intervention was assessed at follow-up visits 6 months later. The patients were divided into poor compliance group (n=41) and good compliance group (n=45). The two groups were compared in demographic characteristics, homeostasis model assessment-insulin resistance (HOMA-IR) and homeostasis model assessment-islet β cell function index (HOMA-β). SPSS statistics 23.0 was employed to process and analyze the data. According to the data type, t test,χ2 test or continuous correctedχ2 test was used for comparison between groups. Binary logistic regression analysis was used to analyze the factors influencing compliance with lifestyle intervention in the elderly patients with newly-diagnosed T2DM. Results HOMA-IR in both groups at follow-up visits was reduced compared with that at the first visit (P<0.05), and HOMA-IR in the good compliance group was lower than that in the poor compliance group (P<0.05). HOMA-β in both groups was enhanced compared with that at the first visit (P<0.05), and HOMA-β in the good compliance group was higher than that in the poor compliance group (P<0.05). Binary logistic regression analysis showed that divorced/widowed (OR=2.633,95%CI 1.513-4.581; P<0.05), living alone (OR=2.326,95%CI 1.218-4.442; P<0.05), and having a family history of diabetes mellitus (OR=0.655,95%CI 0.197-0.983; P<0.05) were contributing factors of poor compliance with lifestyle intervention in the elderly T2DM patients. Conclusion Among the elderly patients with newly-diagnosed T2DM, those with poor compliance with lifestyle intervention have poor islet β cell function and insulin resistance control, the divorced/widowed and the solitary are more likely to have a poor compliance with lifestyle intervention, and those with a family history of diabetes mellitus often have a good compliance.

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黄婵娟,王莹,林云萍,陈萍萍.老年初诊2型糖尿病患者生活方式干预依从性的影响因素[J].中华老年多器官疾病杂志,2024,23(5):369~372

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  • 收稿日期:2023-06-09
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  • 在线发布日期: 2024-05-15
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