目的:社会隔离可能影响糖尿病的自我管理。本研究旨在探讨糖尿病患者社会隔离与血糖控制之间的关系,并探讨不同社会隔离程度的个体之间的生活方式差异。
方法:提取并分析2011-2015年中国健康与退休纵向研究纳入的665例糖尿病患者的相关数据。该研究包括患者的一般信息,血糖,脂质,糖化血红蛋白,社会隔离指数,健康相关的生活方式因素和糖尿病相关因素。在社会隔离程度不同的患者中,比较了代谢异常和可改变的生活方式的差异。
结果:多元线性回归分析表明,在45-64岁的男性中,与低隔离组相比,高社会隔离组的糖化血红蛋白水平显著较高(7.29±1.81vs6.59±1.63,p=0.026).社会隔离与血糖(β=14.16;95%CI2.75至25.57;p=0.015)和糖基化血红蛋白(β=0.35;95%CI0.10至0.60;p=0.006)之间呈正相关,表明较高的社会隔离与较高的空腹血糖和糖化血红蛋白水平相关。然而,在其他年龄组未观察到显著关联.值得注意的是,年龄在45-65岁之间、社会隔离程度较高的男性患抑郁症的比例较高(44.10%vs24.60%,p=0.024),适度运动的参与度较低(5.70%对23.50%,p=0.019)和较短的10分钟步行(17.10%对36.80%,p=0.027)。其他健康相关和糖尿病相关因素的差异无统计学意义。
结论:社会隔离程度较高的中年糖尿病男性往往有较高的血糖和糖化血红蛋白水平。这部分患者需要有针对性的关注,以提供家人和朋友的社会支持,以改善血糖控制。如有必要,糖尿病教育应提供给家人和朋友。
OBJECTIVE: Social isolation may affect diabetes self-management. This study aimed to explore the relations between social isolation and glycaemic control in patients with diabetes and to explore lifestyle differences among individuals with different levels of social isolation.
METHODS: The relevant data of 665 people previously diagnosed with diabetes included in the
China Health and Retirement Longitudinal Study from 2011 to 2015 were extracted and analysed. The study included patient general information, blood glucose, lipids, glycosylated haemoglobin, social isolation index, health-related lifestyle factors and diabetes-related factors. Differences in metabolic abnormalities and modifiable lifestyles were compared among patients with varying levels of social isolation.
RESULTS: Multiple linear regression analysis demonstrated that among men aged 45-64 years, the high social isolation group had significantly higher glycosylated haemoglobin levels compared with the low isolation group (7.29±1.81 vs 6.59±1.63, p=0.026). A positive correlation was observed between social isolation and blood glucose (β=14.16; 95% CI 2.75 to 25.57; p=0.015) and glycosylated haemoglobin (β=0.35; 95% CI 0.10 to 0.60; p=0.006), indicating that higher social isolation was associated with higher fasting blood glucose and glycosylated haemoglobin levels. However, no significant associations were observed in other age groups. Notably, men aged 45-65 years with high social isolation had higher depression rates (44.10% vs 24.60%, p=0.024), lower engagement in moderate exercise (5.70% vs 23.50%, p=0.019) and shorter 10-minute walks (17.10% vs 36.80%, p=0.027). Differences in other health-related and diabetes-related factors were not statistically significant.
CONCLUSIONS: Middle-aged men with diabetes with higher social isolation tend to have higher blood glucose and glycosylated haemoglobin levels. This subset of patients requires targeted attention to provide social support from family and friends for improved glycaemic control. If necessary, education on diabetes should be made available to family members and friends.