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당뇨병 관리전략을 위한 혈당조절 관련 생활습관 요인: 국민건강영양조사 활용 코호트내 환자-대조군 연구

Lifestyle factors related to glucose control for diabetes management strategies: Nested case control design using KNHANES data

  • 투고 : 2019.10.04
  • 심사 : 2019.11.20
  • 발행 : 2019.11.28

초록

본 논문은 당뇨병의 관리전략 수립을 위해 일상생활에서 조절가능한 혈당조절 요인을 파악하고자 하였다. 개인이 조절하기 어려운 성별, 당뇨병 유병기간, 당뇨병 치료방법, 교육수준, 가구소득 등을 매칭한 코호트내 환자-대조군 디자인으로 분석을 하였다. 7기 국민건강영양조사(2016-2017) 원시자료를 이용하여, 983명의 당뇨병 환자를 분석한 결과, 289명(30%)만이 당화혈색소가 6.5% 미만으로 혈당이 조절되었다. 일상생활에서 조절이 가능한 당화혈색소 조절 요인 파악하기 위해 조건부 다변량 로짓스틱 회귀분석 시행한 결과, 매칭전 코호트에서는 당뇨병 유병기간, 당뇨병 치료 여부, 매칭 코호트에서는 체질량지수, 흡연, 안저검사가 당화혈색소 달성에 유의한 영향을 미치는 것으로 파악되었다. 본 결과는 집중 관리가 필요한 대상선정(장기 유병기간, 약물치료 대상자) 및 생활습관(체질량지수, 흡연, 안저검사 등) 관리전략을 마련하는데 근거자료로 활용되고, 지역사회내 국민건강 증진에 기여할 것으로 사료된다.

This study aimed to find health related lifestyle factors that influence glycemic control for diabetes mellitus (DM) management strategies. This study used nested case-control design with matching variables that were not controlled by individuals such as age, sex, insulin or oral hypoglycemic agent (OHA) use, disease duration, education level and household income. This study analyzed 983 subjects with type 2 DM who enrolled in the $7^{th}$ (2016-2017) Korean National Health and Nutrition Examination Survey (KNHANES). The target HbA1c level of controlled glucose was defined as less than 6.5%, and 289 (30%) were achieved. Conditional multivariable logistic regression analysis was performed to find self-control factors associated with HbA1c levels. The results statistically significant for variables such as duration of diabetes, insulin or OHA use in overall cohort and body mass index (BMI), smoking and fundus Examination in matched cohort. These results are expected to provide as evidence for the intensive care criteria(disease duration, drug use) and lifestyle management strategy(BMI, smoking, fundus examination).

키워드

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