Objective To investigate the control status of glycosylated hemoglobin (HbA1c) in the middle aged and elderly patients with type 2 diabetes mellitus (T2DM) in Lanzhou communities and analyze its influencing factors.Methods A total of 1 120 individuals having diagnosed T2DM aged 40-75 years in Lanzhou communities were selected.Questionnaire was conducted.Height,weight,blood pressure and lipid were examined.Body mass index (BM1) was calculated.The index were analyzed.Results The patients with HbA1c less than 7.0％ were 453 cases (40.4％,453/1 120),and HbA1c more than or equal to 7.0％ were 667cases (59.6％,667/1 120).The target rate of HbA1c in the patients receiving life style,one oral antidiabetic drug,more oral antidiabetic drug,insulin therapy were 49.2％(94/191),45.7％(182/398),41.5％(88/212) and 27.9％(89/319),respectively.The target rate of HbA1c were 38.6％(192/298),32.2％(49/152),32.7％(49/150),27.0％(85/315) in the patients overweight or obese,with macro or micro vascular complication,and 60.0％ (12/20),44.4％(200/450),41.6％(404/970),45.7％(368/805) in the patients without overweight or obese and macro or micro vascular complication,and there were significant differences (P ＜ 0.01 or ＜ 0.05).Multivariate Logistic regression analysis showed that the extension duration of diabetes,increased BMI,combining with macro or micro vascular complication and gradual strengthening antidiabetic treatment were independent risk factors for HbA1c target (P ＜ 0.05).Conclusions Current status of HbA1c control in the middle aged and elderly patients with T2DM in Lanzhou communities is not optimistic,which is affected by many factors,suggesting that professional education on management should be further strengthened.And optimal treatment programs and individualized comprehensive treatment are needed for most patients to improve glycemic control.

Objective:To analyze and compare the association between different obesity-related indices and vitamin D deficiency in middle-aged and elderly population dwelled in Lanzhou city.Methods:From May, 2011 to September, 2012, middle-aged and elderly individuals with complete baseline data were included via randomly cluster sampling from 3 communities in Lanzhou. The subjects were divided into 4 subgroups by vitamin D levels and various obesity-related indices were compared across subgroups with the same gender. The relationship between the obesity-related indices and the severity of vitamin D deficiency was analyzed using Spearman correlation analysis, and the effects of different obesity-related indices on the severity of vitamin D deficiency was analyzed using multivariate logistic regression analysis.Results:A total of 9 437 residents were included. The overall prevalence of vitamin D deficiency was 97.7%. Compared with the group with lower vitamin D level, participants in the group with higher vitamin D level showed evidently lower body mass index (BMI), waist circumference (WC), lipid accumulation product (LAP), visceral adiposity index (VAI) and triglyceride/ high density lipoprotein cholesterol (TG/HDL-C) ratio in the total population and females, while only WC, LAP, VAI and TG/HDL-C in the males (all P<0.05). Spearman correlation analysis showed that BMI, WC, LAP, VAI and TG/HDL-C were positively correlated with the severity of vitamin D deficiency in the total population and the females, while only LAP, VAI and TG/HDL-C in the males (all P<0.05) . Multivariate logistic regression analysis showed that higher levels of these obesity related indices were correlated with more severe vitamin D deficiency in the total population and the females, while only higher LAP, VAI and TG/HDL-C in the males (all P<0.05). The effects of higher LAP was the most prominant in the total population ,the females and the males. Conclusion:Various obesity phenotypes are closely related to vitamin D deficiency in middle-aged and elderly women, while only visceral obesity and abnormal lipid metabolism are related to vitamin D deficiency in middle-aged and elderly men, with LAP being the most important influencing factor.

OBJECTIVE: To explore the correlation of different glucose metabolism statues with chronic kidney disease (CKD) in middle-aged and elderly individuals in Lanzhou. METHODS: Based on the baseline data of REACTION Study in Lanzhou area, we randomly sampled 10 038 residents aged 40-75 years in 3 communities in Lanzhou, who were classified into normal glucose tolerance (NGT), impaired glucose regulation (IGR) and diabetes groups. The estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (ACR) were used to assess the renal function and albuminuria, respectively. Binary logistic regression was performed to analyze the contribution of the risk factors to CKD. Polynominal regression was used to determine the trends of eGFR with the increment of ACR. RESULTS: Among all the participants, the prevalences of albuminuria, CKD and renal insufficiency (RI) were 26.2%, 27.4% and 2.5%, respectively. The prevalence of albuminuria, CKD and RI were significantly higher in the diabetes group than in IGR and NGT groups ( CONCLUSIONS Diabetes mellitus is a significant risk factor for albuminuria and RI, while IGR is not. Screening for albuminuria and eGFR is highly recommended for individuals with diabetes, hypertension, and obesity, especially in women and the elderly population.
Adult ; Aged ; Albuminuria/epidemiology* ; Diabetes Mellitus, Type 2/epidemiology* ; Female ; Glomerular Filtration Rate ; Glucose ; Humans ; Middle Aged ; Prevalence ; Renal Insufficiency, Chronic/epidemiology* ; Risk Factors