以前糖尿病と診断された成人における血管疾患の危険因子の制御が不十分である

Sharon H Saydah¹, Judith Fradkin, Catherine C Cowie

¹US Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, Md, USA.

JAMA

|January 22, 2004

まとめ

血糖,血圧,コレステロールなどの血管疾患の危険因子は,糖尿病の米国成人では依然として制御が不十分である. 公共衛生の取り組みは,管理を改善し,健康上のリスクを軽減するために不可欠です.

科学分野:

心血管の健康についてです.
内分泌学エンドックリノロジー
公衆衛生は公衆衛生である.

背景:

糖尿病における血管疾患のリスク軽減は,血糖,血圧,コレステロールのコントロールに依存しています.
米国の糖尿病患者集団におけるこれらのリスクファクターコントロールの現在の状態はよく定義されていません.

研究の目的:

糖尿病と診断された成人における血管疾患の危険因子制御に関する1999-2000年の国家データを分析する.
過去10年間のリスク因子管理の動向を評価する.

主な方法:

国家保健栄養調査 (NHANES III,1988-1994) とNHANES 1999-2000からのデータを活用した.
糖尿病と診断された米国の成人の全国的に代表的なサンプルで,ターゲット目標に対して,グリコシル化ヘモグロビン (HbA1c),血圧,および血清全コレステロールレベルを分析した.

主要な成果:

1999年から2000年にかけて,HbA1cの目標値 (<7.0%) を満たした成人糖尿病患者の割合は37.0%に過ぎず,NHANES IIIから有意な変化はありませんでした.
血圧制御 (SBP <130 mm Hg,DBP <80 mm Hg) は,わずか35.8%で達成され,また,有意な傾向の変化も示されなかった.
総コレステロールレベル (≥200 mg/dL) は,NHANES III (66.1%から51.8%) から著しく低下したが,成人の7.3%だけが3つのリスク因子目標 (HbA1c,血圧,コレステロール) を同時に達成した.

結論:

主要な血管疾患の危険因子のコントロールは,糖尿病と診断された米国の成人の間で最適ではないままです.
これらのリスク要因の管理を改善し,血管疾患のリスクを軽減するために,強化された公衆衛生戦略が必要である.

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