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1999—2018年的美国成人糖尿病治疗和控制趋势
Trends in Diabetes Treatment and Control in U.S. Adults, 1999–2018


Michael Fang ... 糖尿病 • 2021.06.10
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摘要


背景

记录当前的糖尿病治疗和危险因素控制趋势可能有助于指导公共卫生政策和规划。

 

方法

我们对参与美国全国健康和营养调查(National Health and Nutrition Examination Survey,NHANES)的成人糖尿病患者数据进行了一项横断面分析,旨在评估从1999—2018年,全国的糖尿病治疗和危险因素控制趋势。

 

结果

从1999年至21世纪10年代初,参与者的糖尿病控制情况改善,但之后停滞并恶化。从2007—2010年至2015—2018年,NHANES参与者中实现血糖控制(糖化血红蛋白水平,<7%)的成人糖尿病患者比例从57.4%(95%置信区间[CI],52.9~61.8)下降至50.5%(95% CI,45.8~55.3)。血脂控制(非高密度脂蛋白胆固醇水平,<130 mg/dL)情况在21世纪10年代初取得大幅改善后,从2007—2010年(52.3%;95% CI,49.2~55.3)至2015—2018年(55.7%;95% CI,50.8~60.5)改善很小。从2011—2014年至2015—2018年,实现血压控制(<140/90 mmHg)的参与者比例从74.2%(95% CI,70.7~77.4)下降至70.4%(95% CI,66.7~73.8)。同时实现全部三个目标的参与者比例在2010年后趋于稳定,2015—2018年为22.2%(95% CI,17.9~27.3)。使用任何降糖药或降压药的参与者比例在2010年后保持不变,使用他汀类药物的参与者比例在2014年后趋于稳定。2010年后,联合治疗的应用在血压控制不佳的参与者中减少,在血糖控制不佳的参与者中趋于稳定。

 

结论

在1999年至21世纪10年代初的持续十多年改善之后,NHANES中成人糖尿病患者的血糖和血压控制情况恶化,而血脂控制情况趋于稳定(由美国国立心肺血液研究所资助)。





作者信息

Michael Fang, Ph.D., Dan Wang, M.S., Josef Coresh, M.D., Ph.D., and Elizabeth Selvin, Ph.D., M.P.H.
From the Welch Center for Prevention, Epidemiology, and Clinical Research and the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore. Address reprint requests to Dr. Selvin at the Welch Center for Prevention, Epidemiology, and Clinical Research and the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 2024 E. Monument St., Baltimore, MD 21287, or at eselvin@jhu.edu.

 

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