Birinci basamak merkez laboratuvarı HbA1c verilerine göre Hatay’da glisemik kontrol durumu ve ilişkili faktörler

Year 2022, Volume: 20 Issue: 1, 26 - 36, 01.04.2022

Cansu Karabiber Nazan Savaş

https://doi.org/10.20518/tjph.853697

Cited By: 1

Abstract

Amaç: HbA1c glisemik kontrolü, diyabetik komplikasyon riskini ve diabetik bakım kalitesini gösteren bir kan parametresidir. Bu çalışmada Hatay’da Aile Sağlığı Birimleri’nde (ASB) HbA1c tetkiki yapılan 18≤yaş bireylerde HbA1c durumu saptanarak, HbA1c’nin sosyodemografik özellikler, kan lipit profili ve böbrek fonksiyon belirteçleriyle arasındaki ilişkinin değerlendirilmesi amaçlanmıştır. Yöntem: Kesitsel nitelikteki araştırmada Hatay Birinci Basamak Merkez Laboratuvarı’nda Ekim-Aralık.2017 döneminde 18≤yaş bireylerin (n=22943) Hba1c, trigliserit, total kolesterol, yüksek dansiteli lipoprotein (HDL), düşük dansiteli lipoprotein (LDL), üre ve kreatinin verileri retrospektif değerlendirilmiştir. Değerlendirmede laboratuarın referans değerleri kullanılmış, HbA1c’nin ≥%6.5 olması kötü glisemik kontrol kabul edilmiştir. İstatistiksel analizlerde; HbA1c bağımlı değişken, ilçe, uyruk, cinsiyet, yaş ve diğer laboratuvar verileri bağımsız değişken olarak alınmış, tanımlayıcı istatistik, ki-kare ve Mann Whitney-U testleri kullanılmıştır. p<0.05 önemli kabul edilmiştir. Bulgular: HbA1c tetkiki yapılanların yaş ortalaması 47.1±15.7, %72.4’ü kadın, %99.2’si TC vatandaşı olup, %15.4’ünün HbA1c düzeyi ≥%6.5’dir. Kadınların %13.0’ının, erkeklerin %21.9’unun HbA1c düzeyi ≥%6.5’dir (p<0.001). TC vatandaşlarının %15.4’ünün, Suriyeli sığınmacıların %14.2’sinin HbA1c düzeyi ≥%6.5’dir (p=0.662). HbA1c düzeyi ≥%6.5 en fazla olan ilçeler; Kumlu(%37.1), Belen(%22.7) ve Payas’tır(%21.8). HbA1c ≥%6.5 olan bireylerin %54.5’inde Trigliserit ≥150 mg/dl, %46.7’sinde Total Kolesterol ≥200 mg/dl ve %36.3’ünde LDL ≥130 mg/dl, kadınların %91.2’sinin, erkeklerin %91.1’inin HDL düzeyi <65mg/dl’dir (p<0.001). HbA1c ≥%6.5 olan 18-64 yaş bireylerin %3.1’inin, 65≤ yaş bireylerin ise %3’ünün üre düzeyi ≥50 mg/dl, kadınların %10.7’sinin, erkeklerin %7.5’inin kreatinin düzeyi ≥0.9 mg/dl’dir. Sonuç: Hatay’da ASB’lerde 18≤yaş HbA1c bakılan her altı kişiden biri kötü glisemik kontrole sahiptir. Erkeklerde, ileri yaşlarda ve küçük ilçelerde yaşayanlarda glisemik kontrol daha kötüdür. Glisemik kontrolü kötü olan bireylerin kan lipit profili ve böbrek fonksiyon belirteçleri anormal sınırlar içindedir.

Keywords

HbA1c, glisemik kontrol, birinci basamak

Glycemic control status according to HbA1c data of primary care center laboratory and related factors in Hatay

Abstract

Objective: HbA1c is a blood parameter showing glycemic control, risk of diabetic complications and diabetic care quality. In this study, it was aimed to evaluate the relationship between sociodemographic characteristics, blood lipid profile and renal function markers by determining the HbA1c status in 18≤ year old individuals whose HbA1c was examined in Family Health Units (FHU) in Hatay. Methods: In a cross-sectional study, Hba1c, triglyceride, total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), urea and creatinine data were evaluated retrospectively in individuals aged 18≤ (n=22943) between October-December 2017 at the Hatay Primary Care Center Laboratory. Laboratory reference values were used in the evaluation and ≥6.5% HbA1c was accepted as bad glycemic control. In statistical analysis; HbA1c dependent variable, district, nationality, gender, age and other laboratory data were taken as independent variables. Descriptive statistics, chi-square and Mann Whitney-U tests were used. p<0.05 was considered as significant.Results: The average age of those who underwent HbA1c examination was 47.1±15.7, 72.4% were female, 99.2% were Turkish citizens, and 15.4% had an HbA1c level of ≥6.5%. The HbA1 clevel of 13.0% of women and 21.9% of men is ≥6.5% (p <0.001). The HbA1c level of 15.4% of Turkish citizens and 14.2% of Syrian refugees is ≥6.5% (p=0.662). Districts with the highest HbA1c level of ≥6.5%; It is Kumlu (37.1%), Belen (22.7%) and Payas (21.8%). Individuals with HbA1c ≥6.5% had levels of Triglycerides ≥150 mg/dl in 54.5%, of Total Cholesterol ≥200 mg/dl in 46.7% and of LDL ≥130 mg/dl in 36.3%; and 91.2% of women and 91.1% of men had HDL levels <65mg/dl (p <0.001). HbA1c was ≥6.5% of 3.1% 18-64 year-olds and 3% of 65≤ years-old had urea levels of ≥50mg /dl; and 10.7% of women and 7.5% of men had creatinine levels of ≥0.9 mg/dl. Conclusion: One out of every six people aged 18≤ HbA1c analyzed in FHU in Hatay has poor glycemic control. Glycemic control is worse in men, elderly people and those living in small districts. The blood lipid profile and kidney function indicators of individuals with poor glycemic control are in abnormal limits.

Keywords

HbA1c, glycemic control, primary healthcare

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