成人身高与糖尿病控制:有关联吗?

R. Chetty, S. Pillay
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摘要

背景:肥胖通常与糖尿病(DM)相关。最常用来评估肥胖的人体测量指数是身体质量指数(BMI),它使用身高和体重作为变量,但不使用身高作为独立分析变量。目前还没有关于HIV感染的糖尿病患者(PLWD)成人身高与血糖控制之间关系的数据。目的:本研究旨在确定HIV流行地区成人最终身高与血糖控制之间的关系。方法:使用2019年1月1日至2019年12月31日来自南非彼得马里茨堡Edendale医院DM诊所的标准化临床表格。进行统计分析。结果:本研究有957例PLWD。在身高< 1.40 m、1.40 - 1.49 m、1.50-1.59 m、1.60-1.69 m、1.70-1.79 m、1.80-1.89 m和≥1.90 m类别中,分别有11例、60例、321例、343例、121例、26例和2例(其中73例无身高记录)。较高的患者腰围较小,血糖控制较差。最低与最高(< 1.40 m vs≥1.90 m)组HbA1c值分别为8.49%与12.45%,p = 0.019。身高与舒张压(DBP)呈正相关(p = 0.001)。与其他身高类别相比,身高在1.80-1.89 m的PLWD患者的甘油三酯水平较高,高密度脂蛋白(HDL)水平较低。PLWD较短且血糖控制不受控制的患者收缩压明显升高。性别和HIV感染对PLWD的身高类别影响不显著。结论:身高越高,血糖控制越差。增高与舒张压增高密切相关。舒张压和甘油三酯水平较高,高密度脂蛋白水平较低,这些PLWD属于心血管风险较高的类别。在PLWD患者中,尤其在高个患者中,需要高度重视血脂和血压的监测。
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Adult height and diabetes control: is there an association?
Background: Obesity is commonly associated with diabetes mellitus (DM). The most frequent anthropometric index utilised to assess obesity is the body mass index (BMI), which uses height and weight as variables, but eliminates height as an independent analytical variable. Currently there are no data available on the relationship between adult height and glycaemic control in patients living with diabetes (PLWD) within the context of HIV infection. Objectives: This study aimed to determine an association between final adult height and glycaemic control in an HIV endemic area. Methods: Standardised clinic sheets were used from the DM clinic at Edendale Hospital, Pietermaritzburg, South Africa, from January 1, 2019 to December 31, 2019. Statistical analysis was done. Results: This study had 957 PLWD. In the height categories of < 1.40 m, 1.40–1.49 m, 1.50–1.59 m, 1.60–1.69 m, 1.70–1.79 m, 1.80–1.89 m and ≥ 1.90 m, there were 11, 60, 321, 343, 121, 26 and 2 patients respectively (with 73 patients having no height recorded). Taller patients had smaller waist circumferences and had poorer glycaemic control. In the lowest vs. highest height (< 1.40 m vs ≥ 1.90 m) categories, the HbA1c values were 8.49% vs. 12.45%, respectively, p = 0.019. Height had a strong positive association with diastolic blood pressure (DBP) (p = 0.001). Those PLWD in the 1.80–1.89 m height cohort had higher triglyceride levels and lower high-density lipoprotein (HDL) levels when compared with the other height categories. Shorter PLWD with uncontrolled glycaemic control had significantly elevated systolic blood pressure. Gender and HIV infection had a non-significant role on height categories in PLWD. Conclusion: Taller height categories had poorer glycaemic control. Increasing height was strongly associated with increasing DBP. A higher DBP and triglyceride level with lower HDL level places these PLWD in a higher cardiovascular risk category. Strong emphasis needs to be placed on the monitoring of lipids and blood pressure in PLWD, this more especially in taller patients.
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