2015—2017年北京市2型糖尿病患者骨关节炎患病的相关因素

doi:10.19723/j.issn.1671-167X.2021.03.013

摘要/Abstract

摘要：

目的: 利用大数据对2型糖尿病患者骨关节炎的患病情况和相关因素进行探究,为该类合并症的防治工作提供科学依据。方法: 利用2015—2017年北京市所有定点医疗机构的就诊数据,收集成年2型糖尿病患者的相关资料进行描述性分析,采用Logistic回归模型探究2型糖尿病患者骨关节炎患病的相关因素。结果: 共纳入1 046 264例成年2型糖尿病患者,平均年龄63.07岁,男性占50.78%。2型糖尿病患者中患有骨关节炎的病例341 561人,患病率为32.65%;女性患病率(38.05%)高于男性(27.41%),差异有统计学意义(P<0.05)。2型糖尿病患者骨关节炎在各个年龄段均有发生,骨关节炎患病率最高的年龄组为65~69岁组(36.76%),患病率最低的年龄组为≤44岁组(14.3%),70岁前患病率随年龄组的升高而增加。进一步分析2型糖尿病患者骨关节炎患病的影响因素,发现女性(OR=1.62,95%CI:1.61~1.63)、年龄(OR=1.01,95%CI:1.01~1.01)、患有其他合并症(OR=1.19,95%CI:1.18~1.21)、使用降糖药(OR=0.79,95%CI:0.78~0.80)、患有心血管疾病(OR=1.13,95%CI:1.11~1.15)、患有脑血管疾病(OR=1.25,95%CI:1.23~1.28)、患有糖尿病肾病(OR=1.61,95%CI:1.51~1.71)等因素与2型糖尿病人群患骨关节炎有关。结论: 北京地区2型糖尿病患者骨关节炎的患病率较高,应对中老年患者加强健康宣教与疾病监测工作,重点关注绝经期妇女,尽早开展合并症筛查工作。

关键词: 糖尿病,2型, 骨关节炎, 共病现象, 患病率

Abstract:

Objective: To explore the prevalence and related factors of osteoarthritis in patients with type 2 diabetes mellitus, and provided a scientific basis for the prevention of the comorbidity. Methods: The data were obtained from the database of all designated medical institutions in Beijing from 2015 to 2017. Data of the adult patients with type 2 diabetes mellitus were collected for descriptive analysis, and a Logistic regression model was used to explore the related factors of osteoarthritis in the patients with type 2 diabetes mellitus. Results: A total of 1 046 264 diagnosed type 2 diabetes mellitus adult patients were included in our study, with an average age of 63.07 years, and 50.78% were males. Among the patients with type 2 diabetes mellitus, there were 341 561 cases with osteoarthritis, and the prevalence of osteoarthritis was 32.65%. The prevalence of females (38.05%) was higher than that of males (27.41%), and the difference was statistically significant (P<0.05). Osteoarthritis occurred in all age groups among the patients with type 2 diabetes mellitus, with the highest prevalence of osteoarthritis in the age group of 65-69 years (36.76%), and the lowest prevalence in the age group ≤44 years (14.3%). Before the age of 70, the prevalence increased with age. Further analysis of related factors for osteoarthritis in the patients with type 2 diabetes mellitus showed that female (OR=1.62, 95%CI: 1.61-1.63), age (OR=1.01, 95%CI: 1.01-1.01), had other comorbidities (OR=1.19, 95%CI: 1.18-1.21), used hypoglycemic drugs (OR=0.79, 95%CI: 0.78-0.80), having the cardiovascular disease (OR=1.13, 95%CI: 1.11-1.15), having cerebrovascular disease (OR=1.25, 95%CI: 1.23-1.28), and having nephropathy (OR=1.61, 95%CI: 1.51-1.71) were associated with the osteoarthritis in the type 2 diabetic mellitus patients. Conclusion: Our study revealed that the prevalence of osteoarthritis in patients with type 2 diabetes mellitus is high in Beijing area. Health education and disease monitoring should be strengthened in middle-aged and elderly patients. Screening for comorbidities should be carried out as soon as possible, with the focus on menopausal women.

Key words: Diabetes mellitus,type 2, Osteoarthritis, Comorbidity, Prevalence

中图分类号:

R181.3

吴俊慧,陈泓伯,武轶群,吴瑶,王紫荆,吴涛,王梦莹,王斯悦,王小文,王伽婷,于欢,胡永华. 2015—2017年北京市2型糖尿病患者骨关节炎患病的相关因素[J]. 北京大学学报（医学版）, 2021, 53(3): 518-522.

WU Jun-hui,CHEN Hong-bo,WU Yi-qun,WU Yao,WANG Zi-jing,WU Tao,WANG Meng-ying,WANG Si-yue,WANG Xiao-wen,WANG Jia-ting,YU Huan,HU Yong-hua. Prevalence and risk factors of osteoarthritis in patients with type 2 diabetes in Beijing, China from 2015 to 2017[J]. Journal of Peking University (Health Sciences), 2021, 53(3): 518-522.

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参考文献 16

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Characteristics	With osteoarthritis(n=341 561)		Without osteoarthritis(n=704 703)		Total(n=1 046 264)
Characteristics	n	%	n	%	n	%
Gender
Male	145 615	42.63	385 722	54.74	531 337	50.78
Female	195 946	57.37	318 981	45.26	514 927	49.22
Age group
≤44 years	13 407	3.93	61 650	8.75	75 057	7.17
45-54 years	48 873	14.31	121 812	17.29	170 685	16.31
55-64 years	120 204	35.19	228 786	32.47	348 990	33.36
65-74 years	82 241	24.08	142 097	20.16	224 338	21.44
≥75 years	76 836	22.50	150 358	21.34	227 194	21.71
Comorbidity
Yes	40 387	11.82	94 502	13.41	134 889	12.89
No	301 174	88.18	610 201	86.59	911 375	87.11
Use of hypoglycemic drugs
Yes	257 246	75.31	501 560	71.17	758 806	72.53
No	84 315	24.69	203 143	28.83	287 458	27.47

Characteristics	Age group					Total
Characteristics	≤44 years	45-54 years	55-64 years	65-74 years	≥75 years	Total
Cardiovascular disease	7.70	14.57	18.40	24.52	35.36	22.72
Cerebrovascular disease	5.65	9.12	11.02	15.07	24.62	14.57
Nephropathy	3.07	1.62	1.31	1.49	1.72	1.56
Eye diseases	0.97	0.65	0.66	0.68	0.48	0.64

Variable	Model 1			Model 2			Model 3
Variable	OR	95%CI	P	OR	95%CI	P	OR	95%CI	P
Female	1.63	1.62-1.65	<0.01	1.62	1.61-1.63	<0.01	1.62	1.61-1.63
Age	1.01	1.01-1.02	<0.01	1.02	1.01-1.02	<0.01	1.01	1.01-1.02	<0.01
Comorbidity				1.19	1.18-1.21	<0.01
Use of hypoglycemic drugs				0.79	0.78-0.80	<0.01
Cardiovascular disease							1.13	1.11-1.15	<0.01
Cerebrovascular disease							1.25	1.23-1.28	<0.01
Eye diseases							1.03	0.94-1.13	0.44
Nephropathy							1.61	1.51-1.71	<0.01