上海预防医学2025，Vol.37Issue(1)：53-59,7.DOI:10.19428/j.cnki.sjpm.2025.24244
上海市社区2型糖尿病患者脑卒中发病及影响因素
Incidence and influencing factors of stroke in type 2 diabetes patients in the community of Shanghai
摘要
Abstract
[Objective]To investigate the incidence of stroke in patients with type 2 diabetes mellitus(T2DM)in the community of Shanghai,and to explore its influencing factors.[Methods]A two-way cohort study was used to observe the incidence of stroke in a dynamic cohort of 14 743 community-based T2DM patients who were enrolled for management from January 2016 to December 2018 in Hongkou District,Shanghai.All the research subjects were followed up for 3 years to observe the stroke occurrence.Outcome events were retrospectively collected from the Shanghai Stroke and Acute Myocardial Infarction Registry Reporting Information System and the Cause of Death Registry System,and information on stroke onset and verification of past medical history were collected by family physicians through clinic follow-up,home follow-up,and telephone follow-up.Cox proportional hazards model was used to identify the risk factors of stroke in TDM2 patients,and the hazard ratio(HR)and its 95%confidence interval(CI)were calculated.[Results]After a mean follow up of 3.5 years,the standardized incidence of stroke in patients with T2DM was 8.65‰,and the risk of standardized incidence was 3.50(95%CI:3.26‒3.77)compared with that of the total national population.Cox proportional hazards regression analysis showed that age(HR=1.18,95%CI:1.13‒1.23),being female(HR=1.14,95%CI:1.01‒1.29),physical activity<600 metabolic equivalent(MET)·min·week-1(HR=1.24,95%CI:1.06‒1.44),substandard of HbA1c control(HR=1.16,95%CI:1.03‒1.30),occasional smoker(HR=1.23,95%CI:1.04‒1.45),and those who took insulin therapy(HR=1.36,95%CI:1.11‒1.66)were associated with an increased risk of stroke,while those received contracted services from family doctors were associated with a decreased risk of stroke(HR=0.78,95%CI:0.71‒0.88).[Conclusion]Community T2DM population in Shanghai has a high risk of stroke.It is necessary to continue to explore the positive role of family doctor contract service management model,strengthen individualized exercise,smoking cessation and other lifestyle interventions,and strictly control blood glucose as soon as one can to delay or avoid the occurrence of complications.关键词
2型糖尿病/脑卒中/发病/影响因素Key words
type 2 diabetes mellitus/stroke/incidence/risk factor分类
医药卫生引用本文复制引用
刘少博,田娟娟,赵蕴珊,叶景虹..上海市社区2型糖尿病患者脑卒中发病及影响因素[J].上海预防医学,2025,37(1):53-59,7.基金项目
上海市卫生健康委员会科研课题面上项目(201940186) （201940186）
虹口区卫生健康委员会科研课题重大项目(虹卫1801-02) （虹卫1801-02）
