本文選題：老年人 + 糖尿病��； 參考：《蘇州大學(xué)》2015年碩士論文

【摘要】：隨著老年人數(shù)量及其比重的不斷增加,老年人群體的健康日益受到社會(huì)的關(guān)注。糖尿病是影響老年人健康和生活質(zhì)量的重要因素。因此,我們研究影響老年人糖尿病發(fā)病的因素,在此基礎(chǔ)上建立、驗(yàn)證老年人糖尿病發(fā)病風(fēng)險(xiǎn)模型。根據(jù)所建立的模型確定重點(diǎn)干預(yù)人群,進(jìn)而采取有效的、針對(duì)性的干預(yù)措施來(lái)降低老年人糖尿病發(fā)病風(fēng)險(xiǎn)。這對(duì)于提高老年人的生活質(zhì)量、促進(jìn)社會(huì)的發(fā)展和進(jìn)步具有重要意義。目的通過(guò)對(duì)蘇州市相城區(qū)渭塘鎮(zhèn)血糖正常,無(wú)糖尿病發(fā)病史及重大疾病的老年人進(jìn)行為期兩年以糖尿病為結(jié)局的隊(duì)列研究,分析影響老年人糖尿病發(fā)病風(fēng)險(xiǎn)的臨床指標(biāo)、建立及驗(yàn)證老年人糖尿病發(fā)病風(fēng)險(xiǎn)模型。為更好地降低老年人糖尿病發(fā)病風(fēng)險(xiǎn)、提高老年人的身體健康和生活質(zhì)量提供一定的科學(xué)依據(jù)。方法蘇州市相城區(qū)第三人民醫(yī)院開展了針對(duì)老年人的免費(fèi)健康體檢活動(dòng)。我們從老年人健康體檢資料中選擇基線血糖正常老年人進(jìn)行為期兩年以糖尿病為結(jié)局的隊(duì)列研究,應(yīng)用相關(guān)統(tǒng)計(jì)學(xué)軟件分析老年人糖尿病發(fā)病風(fēng)險(xiǎn)影響因素,建立并驗(yàn)證老年人糖尿病發(fā)病風(fēng)險(xiǎn)模型。采用的統(tǒng)計(jì)學(xué)方法主要有單因素logistic回歸、t檢驗(yàn)、多因素logistic回歸、ROC曲線(用來(lái)評(píng)價(jià)模型預(yù)測(cè)結(jié)果)。結(jié)果2011年基線血糖正常老年人共有1610人,到2012年有1610人,到2013年有1588人。失訪人數(shù)(人)為22,比率為1.37%。老年人糖尿病發(fā)病影響因素單因素分析顯示影響老年人群兩年后糖尿病發(fā)病風(fēng)險(xiǎn)的因素為甘油三酯偏高、高血壓、靜息心率過(guò)快、超重、肥胖、空腹血糖損害及糖尿病家族史。它們的OR及95%置信區(qū)間分別為2.080(1.335,3.241)、2.112(1.309,3.407)、2.098(1.378,3.196)、2.474(1.589,3.851)、2.928(1.445,5.933)、11.281(7.234,17.592)及2.425(1.542,3.811)。膽固醇水平,高密度脂蛋白水平,血紅蛋白水平,尿酸及肌酐水平對(duì)老年人兩年后糖尿病發(fā)病風(fēng)險(xiǎn)的影響均無(wú)統(tǒng)計(jì)學(xué)意義。老年人糖尿病發(fā)病風(fēng)險(xiǎn)影響因素多因素分析表明影響老年人群兩年后糖尿病發(fā)病風(fēng)險(xiǎn)的因素有甘油三酯偏高、膽固醇偏高、肥胖、超重、空腹血糖損害和糖尿病家族史。它們的OR和95%置信區(qū)間分別為1.788(1.065,3.122)、0.457(0.231,0.903)、2.302(1.041,5.087)、2.164(1.331,3.518)、9.944(6.249,15.825)和1.926(1.179,3.149)。靜息心率,低密度脂蛋白水平,高密度脂蛋白水平,血紅蛋白水平,尿酸及肌酐水平對(duì)老年人兩年后糖尿病發(fā)病風(fēng)險(xiǎn)的影響均無(wú)統(tǒng)計(jì)學(xué)意義。老年人糖尿病發(fā)病風(fēng)險(xiǎn)模型為：將1588名老年人影響因素基線值帶入糖尿病發(fā)病風(fēng)險(xiǎn)模型求出該老年人群不司個(gè)體的糖尿病發(fā)生概率。經(jīng)過(guò)ROC曲線分析,結(jié)果顯示曲線下面積(AUC)為).828,95%置信區(qū)間為(0.785,0.872),預(yù)測(cè)效果較好。結(jié)論：1.老年人糖尿病發(fā)病風(fēng)險(xiǎn)的影響因素甘油三酯偏高,膽固醇偏高,空腹血糖損害,超重,肥胖,糖尿病家族史。2.所建立的老年人糖尿病發(fā)病風(fēng)險(xiǎn)模型合理,能較好地預(yù)測(cè)老年人糖尿病的發(fā)病情況。
[Abstract]:With the increasing of the number and proportion of the elderly, the health of the elderly has been paid more and more attention. Diabetes is an important factor affecting the health and quality of life of the elderly. Therefore, we study the factors that affect the incidence of diabetes in the elderly, and establish a model to verify the risk of diabetes in the elderly. According to the established model, the key intervention population was determined, and then effective and targeted intervention measures were taken to reduce the risk of diabetes in the elderly. This is of great significance for improving the quality of life of the elderly and promoting the development and progress of the society. Objective to analyze the clinical indexes of diabetes risk in elderly patients with normal blood sugar, no history of diabetes and major diseases in Xiangcheng District of Suzhou City, and to conduct a cohort study on the outcome of diabetes mellitus for a period of two years. To establish and verify the risk model of diabetes in the elderly. It provides a scientific basis for reducing the risk of diabetes and improving the health and quality of life of the elderly. Methods the third people's Hospital of Xiangcheng District of Suzhou carried out free health examination for the elderly. We selected baseline blood glucose from the elderly health examination data to conduct a two-year diabetes outcome cohort study, using the relevant statistical software to analyze the risk factors of diabetes in the elderly. To establish and verify the risk model of diabetes in the elderly. The main statistical methods used are single factor logistic regression t test, multivariate logistic regression and ROC curve (used to evaluate the prediction results of the model). Results there were 1610 elderly people with normal blood glucose in 2011, 1610 in 2012 and 1588 in 2013. The number of people who lost the interview was 22, the ratio was 1.37. Univariate analysis showed that the risk factors of diabetes in the elderly were high triglyceride, high blood pressure, fast resting heart rate, overweight, obesity, impaired fasting blood glucose and family history of diabetes. Their OR and 95% confidence intervals were 2.080 / 1.335/ 3.241U / 2.1121.309/ 3.407/ 2.098 / 1.378/ 3.196 / 2.474 / 1.589 / 3.851/ 2.92828 / 1.4455.933 / 11.2817.234/ 17.592and 2.42551.542/ 3.811. respectively. The levels of cholesterol, high density lipoprotein, hemoglobin, uric acid and creatinine had no significant effect on the risk of diabetes in the elderly two years later. The multivariate analysis of the risk factors of diabetes in the elderly showed that the factors affecting the risk of diabetes were high triglyceride, high cholesterol, obesity, overweight, impaired fasting blood glucose and family history of diabetes. Their OR and 95% confidence intervals were 1.788 / 1.0656 / 3.122 / 0.4570.231/ 0.903 / 2.302/ 1.041 / 5.087 / 3.51818 / 9.9444.249/ 15.825) and 1.9261.179/ 3.149/ 3.149respectively. Resting heart rate, low density lipoprotein level, high density lipoprotein level, hemoglobin level, uric acid and creatinine levels had no significant effect on the risk of diabetes in the elderly two years later. The risk model of diabetes in the elderly was as follows: the baseline value of the influencing factors of 1588 elderly people was brought into the diabetes risk model to find out the probability of diabetes in the elderly population. Through the analysis of ROC curve, the result shows that the area under the curve has a confidence interval of 0.7850.872g, and the prediction effect is better. Conclusion 1. The risk factors of diabetes in the elderly were high triglyceride, high cholesterol, impaired fasting blood glucose, overweight, obesity, family history of diabetes. The established risk model of diabetes in the elderly is reasonable and can predict the incidence of diabetes in the elderly.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R587.1

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