| BackgroundRecently, as the increased development of economy and the acceleration of industrialization process, the morbidity and mortality of coronary disease and ischemic stroke increased significantly in our country, and it brings severe burden and threat to the health of our citizens and to the development of society because of the resulting complications and concomitant. A larger number of studies in domestic and overseas have confirmed that increased of serum total cholesterol, low density, low density lipoprotein cholesterol and the decreased of high density lipoprotein cholesterol is the main risk factors of coronary heart disease and ischemic stroke. The incidence and development of dyslipidemia have been co-influenced by genetic and environmental factors. Existing research shows that the prevalence of dyslipidemia is closely related with the life style such as daily behavior and diet.In the early1980s, several large epidemiological studies with relevance to lipid have been gradually promoted in our country. On the foundation of lipid standardization measurement, the Cardiovascular disease epidemiology research cooperation of China and the United States and Beijing-MONICA international cooperation study have proved that the lipid levels of our citizens significantly lower than in most western counties. The sixth five-year plan to the ninth five-year plan have revealed that serum lipid level and the abnormal rate have significantly difference between different survey area and occupational groups. The result of "residents of nutrition and health survey in China" has showed that the morbidity of hypercholesteremia and hypertriglyceridaemia increased generally in recent decade, and the morbidity of high TG in adult residents of our country was11.9%, and low HDL-C was7.4%. However, in stark contrast to the increasing blood lipid level and abnormal rate in recent years, China’s medical staff knowledge of blood lipid level and abnormal blood lipid control in patients with dyslipidemia conditions are far from the requirements of "adult dyslipidemia prevention advice in China". Therefore, dyslipidemia has become the most serious public health problem, early screening and early intervention of dyslipidemia are extremely urgent.Diabetes mellitus(DM) accompany with dyslipidemia is common in older people, and is a disease which closely focused and seriously affect the normal life in the elderly. Long-term state of hyperglycemia can cause lesions of multiple system organs and resulting in organ dysfunction and failure, which is a major cause of disability and death. And type-2diabetes mellius is coexistence and advanced with many chronic diseases which related to metabolic disturbance, such as dyslipidemia, high blood pressure, high uric acid, the sleep apnea syndrome and fatty liver disease, and it not only seriously influence the quality of human life but also bring heavy mental and economic burden to their family and society. Overweight and obesity is another global diseases which closely associated with social and economic development. Numerous studies have confirmed that both in the developed countries such as Europe and the United States and in the developing countries with low or middle income in Asia, overweight and obesity are major risk factors for illness associated with dyslipidemia, and the incidence of type-2diabetes mellius hypertension, cardiovascular disease and cancer, TC is significantly increased in overweight and obesity groups than in the normal weight groups. Compare with the developed countries, there are larger harm to the health with the elevation of body weight in the developing countries at the same time.In the past20to30years, there are rapid economic growth and great improvement of people’s living standards in Guangdong province. Recently, research shows that morbidity of the chronic non-communicable diseases such as type-2diabetes mellius, obesity and dyslipidemia rise continually in Guangdong province. The characteristics of dyslipidemia and its relationship with disease such as overweight and obesity, type-2diabetes mellius and so on is various in different regions and populations, especially in Guangdong area with economically developed but relatively small race. This study intends to investigate with representative large sample of type-2diabetes mellius patients with overweight or obesity in Guangdong province, relevant statistical analysis, so as to get the crowd lipid data.[Objection]Evaluating and analysing the status of dyslipidemia in the patients with type-2diabetes mellius and combined with overweight or obesity in Guangdong province, and to understand its characteristics and distribution, as well as assessing and discussing the blood lipid levels, complications and comorbidities and treatment status, in order to provide valuable scientific basis for prevention and treatment of dyslipidemia in patients with type-2diabetes mellius and combined with overweight or obesity in Guangdong province.[Methods and materials]A cross-section study of a representative sample of patients with type-2diabetes mellius and combined with overweight or obesity, who had been living in Guangdong Province for more than1year, was conducted in66hospitals in Guangdong Province from August2011to Marth2012. To realize their characteristics and distribution, complications and concomitant diseases, behavioral factors and self-management, physical examination, biochemical index, the current situation of treatment and other aspects of the status quo.SubjectThe method of random sampling was adopted according to the actual situation of Guangdong Province, patients with type-2diabetes mellius and correspond with the diagnose standard of overweight and obesity was chosen within the scope of Guangdong.3051patients with type-2diabetes mellius were involved in this study. The scope of current analysis was restricted to2823subjects with true data.[Contents and methods]The contents of this survey include questionnaire, such as demographic characteristics, condition of diagnosis, situation of complications and concomitant, family history of diabetes, behavioral risk factor and self-management, past bodyweight and waistline, laboratory testing results recently, the situation of current treatment, and physical examination, such as height, weight, waistline, hipline, blood pressure and heart rate. The method of status quo study was used to realize the characteristics and distribution, the self-reported morbidities of complications and concomitant diseases, family history, the level and type of obesity, behavioral risk factors and self-management, the current situation of treatment and other aspects of the status quo to patients with type-2diabetes mellius and combined with overweight or obesity in Guangdong province.[Statistical Method]The original data were type-in and set up the data base of patients with type-2diabetes mellius and combined with overweight or obesity in Guangdong province with the method of Statistical Package of the Social Sciences (SPSS), version18.0for windows (Chinese version) software after checking and rejecting unqualified questionnaire with the method of double blind. All data were analyzed by the SPSS 18.0software. Statistic Department of Southern Medical University was authorized to estimate the sample size. Enumeration data was expressed as constituent ratio (%), measurement data was expressed as X±SD or medians and inter-quartile range when the data was non-normal distribution. Statistic analysis include the descriptive analysis, use chi-square test to analyze enumeration data, One Way ANOVA was used to compared measurement data which are more than two groups, Wilcoxon or rank sum test was used when the data was non-normal distribution or variance heterogeneity. The in section level a=0.05, take bilateral probability when absence of exceptional circumstance.Subject1Questionnaire ScreeningIn this investigation,3051questionnaires were received.2823questionnaires were qualified, with a pass rate of92.53%, in line with epidemiological studies conditions.2Sex and age distribution in overweight and obese type2diabetic in Guangdong Province2823in this investigations with overweight or obese type2diabetic patients were included,1363of them were men, accounted for48.3%, women1460,51.7%. Among them, aged30and below were59, accounting for2.1%;31to45years old416people, accounting for14.7%;46to60years old1096, accounting for38.8%; over the age of60were1252people, accounted for44.3%. Among them,60years of age or older accounted for the majority, the proportion of women was larger than men.3Lipid levels of overweight and obese type2diabetics in Guangdong ProvinceIn this investigation, a total of2793people have been monitored the levels of total cholesterol, the rate of monitoring was98.94%. Total cholesterol overall average level was5.39mmol/L,5.21mmol/L for male,5.50mmol/L for female, which was higher than male. The characteristics of different ages in total cholesterol levels were as follow. Between16-30years old, the average total cholesterol is5.34mmol/L,5.36mmol/L for male,5.27mmol/L for female. Between31-45years old, the average total cholesterol is5.52mmol/L,5.54mmol/L for male,5.46mmol/L for female. Between46-60years old, the average total cholesterol is5.3934mmol/L,5.1683mmol/L for male,5.6060mmol/L for female. Over the age of60, the average total cholesterol is5.2766mmol/L,5.0437mmol/L for male,5.4300mmol/L for female.In this Investigation, a total of2795people have been monitored the levels of triglycerides, the monitoring rate was99.01%. Triglyceride overall average level was2.5163mmol/L,2.7002mmol/L for male,2.3445mmol/L for female, which was higher than male. The characteristics of different ages in triglyceride levels were as follow. Between16-30years old crowd, the average triglyceride was4.6584mmol/L,5.5817mmol/L for male,2.2350mmol/L for female. Between31-45years old, triglyceride average level is3.1831mmol/L,3.4053mmol/L for male,2.0688mmol/L for female. Between46-60years old, triglyceride average level was2.5306mmol/L,2.6838mmol/L for male,2.3864mmol/L for female. Over60years old in average, triglyceride level was2.1817mmol/L.2.0618mmol/L for male,2.2611mmol/L for female.In this investigation, a total of2731people have been monitored the levels of LDL-C, the monitoring rate was96.74%. LDL-C overall average level was3.1004mmol/L,3.0028mmol/L for male,3.1916mmol/Lfor female, which was higher than male. The characteristics of different ages in LDL-C level were as follow. Between16-30years old, LCL-C average was2.8652mmol/L,2.6571mmol/L for male,3.3594mmol/L for female. Between31-45years old, LDL-C average was 3.1406mmol/L,3.0980mmol/L for male,3.2404mmol/L for female. Between46-60years old, LDL-C average was3.1599mmol/L,3.0328mmol/L for male,3.2801mmol/L for female. Over the age of60, LDL-C average was3.0456mmol/L,2.9434mmol/L for male,3.1138mmol/L for female.In this Investigation, a total of2712people t have been monitored the levels of HDL-C, the monitoring rate was96.07%. HDL-C overall average level was1.2228mmol/L,1.1533mmol/L for male,1.2886mmol/L for female, which was higher than male. The characteristics of different ages in HDL-C level were as follow. Between16-30years old, HDL-C average was1.0913mmol/L,1.0821mmol/L for male,1.1131mmol/Lfor female. Between31-45years old, HDL-C average was1.1561mmol/L,1.0957mmol/L for male,1.2987mmol/L for female. Between46-60years old, HDL-C average wasl.2421mmol/L,1.1978mmol/L for male,1.2847mmol/L for female. Over the age of60years old, HDL-C average was1.2339mmol/L,1.1450mmol/L for male,1.2937mmol/L for female.4Morbidity of dyslipidemia in overweight and obese type2diabetics in Guangdong ProvinceMorbidity of hypercholesterolemia. Population in Guangdong Province of overweight and obesity complicated with hypercholesterolemia in patients with type2diabetes accounted for1423/2823, accounting for50.41%, among them male617/2823, female806/2823, male was lower than female. Between16-30years old, morbidity was28/2823, accounting for0.99%; between31-45years old, morbidity was213/2823, accounting for7.54%; between46-60years old,morbidity was567/2823, accounting for20.09%.Over60years old,morbidity was615/2823, accounting for21.79%. According to it, with the growth of the age, the morbidity is increased for hypercholesterolemia.Morbidity of hypertriglyceridemia. Population in Guangdong Province of overweight and obesity complicated with hypertriglyceridemia in patients with type2diabetes accounted for1573/2823, accounting for55.72%, among them male617/2823, female806/2823, male was lower than female. Between16-30years old, morbidity was41/2823, accounting for1.452%; between31-45years old, morbidity was279/2823, accounting for9.883%; between46-60years old, morbidity was611/2823, accounting for21.64%. Over60years old, morbidity was642/2823, accounting for22.74%. Patients with dyslipidemia in overweight and obese type2diabetics in Guangdong Province are more likely to have hypertriglyceridemia. Morbidity of high low-density lipoprotein cholesterol. Population in Guangdong Province of overweight and obesity complicated with high low-density lipoprotein cholesterol in patients with type2diabetes accounted for989/2823, accounting for35.03%, among them male427/2823, female562/2823, male was lower than female. Between16-30years old, morbidity was18/2823, accounting for0.638%; between31-45years old, morbidity was147/2823, accounting for5.207%; between46-60years old, morbidity was407/2823, accounting for14.42%. Over60years old, morbidity was417/2823, accounting for14.77%.Morbidity of low high-density lipoprotein cholesterol. Population in Guangdong Province of overweight and obesity complicated with low high-density lipoprotein cholesterol in patients with type2diabetes accounted for1081/2823, accounting for38.29%, among them male667/2823, female414/2823, male was lower than female. Between16-30years old, morbidity was35/2823, accounting for2.24%; between31-45years old, morbidity was189/2823, accounting for6.695%; between46-60years old, morbidity was389/2823, accounting for13.78%. Over60years old, morbidity was468/2823, accounting for16.58%.5The level of lipid according to different BMI in overweight and obese type2diabetics in Guangdong Province The distribution of cholesterol level according to different BMI For patients with24≤BMI<28,the average level of total cholesterol was5.30mmol/L,28≤BMI <32was5.51mmol/L,32≤BMI<35was5.43mmol/L, BMI≥35,the average level was5.35mmol/L.The distribution of triglyceride level according to different BMI For patients with24≤BMI<28,the average level of triglyceride was2.45mmol/L,28≤BMI<32was2.62mmol/L,32≤BMI<35was3.02mmol/L, BMI≥35,the average level was2.43mmol/L.The distribution of LDL-C level according to different BMI For patients with24≤BMI<28,the average level of LDL-C was3.07mmol/L,28≤BMI<32was3.16mmol/L,32≤BMI<35was3.21mmol/L, BMI≥35,the average level was3.14mmol/L.The distribution of HDL-C level according to different BMI For patients with24≤BMI<28,the average level of HDL-C was1.21mmol/L,28≤BMI<32was1.25mmol/L,32≤BMI<35was1.22mmol/L, BMI≥35,the average level was1.18mmol/L.According to it, for patients with28≤BMI<32, the level of cholesterol was highest, for32≤BMI<35, the level of triglyceride and LDL-C were highest, for BMI≥35, the level of HDL-C was lowest.6The level of lipid according to different WC in overweight and obese type2diabetics in Guangdong ProvinceThe distribution of cholesterol level according to different WC For patients with WC<70,the average level of total cholesterol was5.30mmol/L,70≤WC<80was5.24mmol/L,80≤WC<90was5.42mmol/L,90≤WC<100was5.32mmol/L,,WC≥100,the average level was5.37mmol/L.For patients with WC<70,the average level of triglyceride was1.66mmol/L,70≤WC<80was2.27mmol/L,80<WC<90was2.31mmol/L,90≤WC<100was 2.50mmol/L,,WC≥100,the average level was2.76mmol/L.For patients with WC<70,the average level of LDL-C was3.66mmol/L,70≤WC<80was2.83mmol/L,80≤WC<90was3.21mmol/L,90≤WC<100was3.05mmol/L,,WC≥100,the average level was3.07mmol/L.For patients with WC<70,the average level of HDL-C was1.15mmol/L,70≤WC<80was1.58mmol/L,80≤WC<90was1.20mmol/L,90≤WC<100was1.22mmol/L,,WC≥100,the average level was1.25mmol/L.7Compliance status and treatment for overweight and obese type2diabetics with dyslipidemia in Guangdong ProvinceFor2823overweight and obese type2diabetics,1332of them received lipid-lowering therapy, accounting for47.18%.For the patients receiving lipid-lowering therapy, the compliance rate of triglyceride, LDL-C, male HDL-C, female HDL-C was29.43%、28.30%、26.13%、15.92%respectively.108of them reached the compliance rate of triglyceride and LDL-C, accounting for8.11%. The compliance rate of lipid-lowering therapy was not good enough,For patients with dyslipidemia,81.08%of them received statin therapy,1.43%of them received fibrate therapy,1.43%of them received other therapy,0.23%of them received statin plus other therapy, and0.30%of them received fibrate plus other therapy. So, for overweight and obese type2diabetics with dyslipidemia, the most frequent course of medicine was statin therapy, and the fibrate therapy came second. It was consistent with clinical guideline.conclusion1With the increase of age, the level of all kinds of blood lipid increased significantly, so in overweight and obese type2diabetic patients in Guangdong Province, the age is a risk factor for dyslipidemia. 2For all morbidities of dyslipidemia in overweight and obese type2diabetic patients in Guangdong Province, the morbidity of hypertriglyceridemia run the first and that of hypercholesterolemia second. The morbidities of both high-density lipoprotein cholesterol and low-density lipoprotein cholesterol also increased.3For overweight and obese type2diabetics with dyslipidemia in Guangdong Province, the most frequent course of medicine was statin therapy, and the fibrate therapy came second.4For overweight and obese type2diabetics with dyslipidemia in Guangdong Province, nearly half of them did not receive medicine therapy, which was not consistent with clinical guideline for type2diabetes.5The compliance rate for overweight and obese type2diabetics with dyslipidemia in Guangdong Province was relatively low. It is for this reason that physicians should increase the awareness of lipid therapy compliance for them. |
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