[Full Text] Anemia i loko o nā poʻe maʻi diabetic makua e kipa ana i ka Halemai Nui E

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Anemia ma waena o nā mākua me ka maʻi maʻi e hele ana i kahi haukapila nui ma ʻAitiopa hikina: kahi noiʻi cross-sectional
Teshome Tujuba, 1 Behailu Hawulte Ayele, 2 Sagni Girma Fage, 3 Fitsum Weldegebreal41, Medical Laboratory, Guelmsau General Hospital, Guelmsau City, Ethiopia 2 School of Public Health, Faculty of Health and Medicine, Haramaya University, Harala State, Ethiopia; 3 School of Nursing and Midwifery, Faculty of Health and Medicine, Haramaya University, Ethiopia; 4 Faculty of Health and Medicine, Haramaya University, Harar City, Ethiopia News Agency: Sagni Girma Fage, Faculty of Health and Medical Sciences, Haral University, Ethiopia, Harar, Ethiopia POBox 235 Email giruu06@gmail.com Background: Although anemia is a common disease among diabetic patients, there is very little evidence of anemia in this part of the population in Ethiopia, especially in the research environment. Therefore, the purpose of this study was to evaluate the degree of anemia and related factors in adult diabetic patients treated in a general hospital in eastern Ethiopia. Methods: A cross-sectional study of health basics was conducted on 325 randomly selected adult diabetic patients. Follow-up clinic at the Gramsoe General Hospital in eastern Ethiopia. Use pre-tested structured questionnaires to collect data through interviews and then perform physical and laboratory measurements. Then enter the data into EpiData version 3.1, and use STATA version 16.0 for analysis. Fit a binary logistic regression model to identify factors related to anemia. When p-value<0.05, all statistical tests are declared significant. Results: The degree of anemia in adult diabetic patients was 30.2% (95% confidence interval (CI): 25.4%-35.4%). Men (36%) have higher anemia than women (20.5%). Male (adjusted odds ratio (AOR) = 2.1, 95% CI: 1.2, 3.8), DM ≥ 5 years (AOR = 1.9, 95% CI: 1.0, 3.7), comorbidities (AOR = 1.9, 95) %CI : 1.0, 3.7) and suffering from diabetic complications (AOR = 2.3, 95% CI: 1.3, 4.2) were significantly associated with anemia. Conclusion: Anemia is a moderate to moderate public health problem among adult DM patients in the study subjects. Male gender, the duration of DM, the presence of DM complications, and DM comorbidities are factors related to anemia. Therefore, routine screening and appropriate management should be designed for men, DM patients with long DM duration, and anemia patients with complications and comorbidities, so as to improve the quality of life of patients. Early diagnosis and regular monitoring of diabetes may also help minimize complications. Keywords: Anemia, Diabetes, General Hospital, Eastern Ethiopia
ʻO ka anemia e pili ana i ka emi ʻana o ka nui o nā keʻena koko ʻulaʻula e holo nei (RBC) a / a i ʻole ka emi ʻana o ka hiki ke lawe i ka oxygen ma muli o ka lawa ʻole e hoʻokō i nā pono physiological o ke kino kanaka.1,2 Hoʻopilikia ia i nā ʻāina ulu a hoʻomohala ʻia, no ke olakino kanaka, ka nohona a me ka hoʻokele waiwai.3 Aia ma kahi o 1.62 biliona poʻe me ka anemia ma ka honua, ʻo ia ka 24.8% o ka heluna kanaka o ka honua.4
ʻO ka maʻi diabetes mellitus (DM) he maʻi maʻi maʻi, i māhele ʻia i ke ʻano I_juvenile a i ʻole ka maʻi diabetes-pili i ka insulin a me ka type II_non-insulin-dependent diabetes.5 I nā maʻi maʻi diabetic, ʻo ka anemia ka mea nui ma muli o ka mumū, nā lāʻau lapaʻau, nā hemahema o ka meaʻai, nā maʻi kīkī, e pili ana i nā maʻi autoimmune, 6,7 ka hoʻohaʻahaʻa pili ʻana i ka hana erythropoietin, ka nele o ka hao a i ʻole ka hana, a pōkole ke ola o ke koko ʻulaʻula.8,9 No laila, he mea maʻamau ka anemia i nā maʻi maʻi diabetic.10,11 I nā mākua, ʻo ka prevalence o ka anemia he 24% ma waena o nā wahine o ka hānau keiki (15-49 mau makahiki) a me 15% ma waena o nā kāne 15-49.12
I nā poʻe maʻi me ka DM, ʻoi aku ka nui o ka poʻe me ka maʻi maʻi maʻi a i ʻole ka lawa ʻole o ka renal, ʻo ka prevalence o ka anemia ma kahi o 2 a 3 mau manawa kiʻekiʻe ma mua o ka poʻe maʻi me ka DM ʻole.13,14 Anemia a me ka maʻi diabetes, e like me ka nephropathy, retinopathy, neuropathy, ka hōʻeha maikaʻi ʻole, a me ka maʻi macrovascular [15,16], he hopena maikaʻi ʻole i ka maikaʻi o ke ola o nā maʻi.17-19 ʻOiai ʻo kēia mau ʻoiaʻiʻo, hōʻike nā hōʻike noiʻi ʻaʻole hiki i ka 25% o nā maʻi maʻi maʻi ke ʻike i ka anemia.20,21
ʻO ka ʻike mua ʻana a me ka mālama ʻana i ka anemia ma nā maʻi DM hiki ke kōkua i ka hōʻemi ʻana i ka maʻi maʻi a me ka make, a hoʻomaikaʻi i ko lākou ola.22 Eia naʻe, ma ka laulā, he haʻahaʻa loa ka loiloi o ka anemia i nā maʻi maʻi diabetic ma ʻAitiopa, a i kēia manawa, ʻaʻohe noiʻi kūpono.He ʻoiaʻiʻo kēia ma ka wahi haʻawina.No laila, ke manaʻo nei kēia noiʻi e hoʻohālikelike i ke kiʻekiʻe o ka anemia i nā maʻi maʻi maʻi ma ka Gramsoe General Hospital ma ka hikina ʻAitiopa a hoʻoholo i nā mea e pili ana iā ia.
Ua mālama ʻia ke aʻo ʻana ma Glymso General Hospital (GGH) aia ma Glymso Town, Habro District, Oromiya State, Eastern Ethiopia.Aia ka haukapila ma kahi o 390 mau kilomita ma ka hikina o Addis Ababa, ke kapikala o ʻAitiopa.23 E like me ka hōʻike a ka Habro Woreda Health Office, ʻo GGH kahi kikowaena kuhikuhi no ka 1.4 miliona mau kānaka ma nā wahi hopu a puni.Hāʻawi ia i nā lawelawe mālama olakino ma mua o 90,000 mau maʻi ma kāna mau keʻena a me nā keʻena ʻokoʻa i kēlā me kēia makahiki.ʻO ka Diabetes Clinic kekahi o nā ʻoihana ʻoihana e hāʻawi ana i nā lawelawe i kahi o 660 mau maʻi maʻi maʻi.Aia ʻo Habro District ma kahi kiʻekiʻe o 1800-2000 mika.
Ua mālama ʻia kahi haʻawina cross-sectional e pili ana i ka haukapila mai Iune 9, 2020 a hiki i ʻAukake 10, 2020. ʻO nā poʻe i komo i ke komo ʻana he poʻe maʻi maʻi maʻi maʻi (≥18 makahiki) i ukali ʻia ma GGH.ʻO nā poʻe maʻi maʻi diabetic makua i loaʻa i ka hoʻokahe koko i nā mahina 3 i hala iho nei, nā maʻi i hāpai a hānau ʻia paha a i ʻole i loaʻa i ka maʻi noʻonoʻo, nā mea maʻi i hana ʻia a hoʻokahe koko no kekahi kumu, a me nā maʻi i loaʻa i ka lāʻau parasite intestinal ʻaʻole i hoʻokomo ʻia. .E aʻo.
Hoʻoholo ʻia ka nui o ka laʻana ma o ka hoʻohana ʻana i ka helu helu helu kanaka hoʻokahi a ma muli o nā manaʻo penei: 95% hilinaʻi manawa, 5% hapa hapa, a me ka anemia prevalence o nā maʻi diabetic mai Dessie Referral Hospital ma Northeast Ethiopia (p = 26.7) %).24 Ma hope o ka hoʻohui ʻana i 10% i nā mea pane ʻole, ʻo 331 ka nui o ka laʻana.
660 mau maʻi maʻi maʻi maʻi i hahai ikaika ʻia ma kahi keʻena maʻi diabetes ma GGH.E puunaue i ka huina nui o na ma'i ma'i ma'i diabetic (660) me ka la'ana hope loa (331) no ka loa'a 'ana i 'elua mau manawa la'ana.Ma ka hoʻohana ʻana i ka papa inoa o nā maʻi maʻi maʻi maʻi e loaʻa ana i nā lawelawe mālama maʻi diabetes ma ka haukapila ma ke ʻano he sampling frame, ua hoʻohana mākou i kahi ʻenehana hoʻāno like ʻole e hoʻokomo i nā mea maʻi ʻē aʻe a pau i ke aʻo ʻana.Hāʻawi i kēlā me kēia mea hoʻopaʻa haʻawina me kahi helu ʻike kūʻokoʻa e pale aku i ka hana hou ʻana, inā e puka hou mai ka maʻi like i ka wā o ke aʻo ʻana no kahi hahai hou.
E hōʻiliʻili i nā ʻikepili e pili ana i nā ʻano sociodemographic, inu ʻawaʻawa, puhi, a me nā ʻano meaʻai ma o ka hoʻohana ʻana i kahi nīnau nīnau i hoʻonohonoho ʻia mai ke ala aʻe i kēlā me kēia ʻanuʻu o ka manual maʻi maʻi maʻi maʻi ʻo WHO.25 ʻO ka ʻai ʻana i ke kī a me ke kofe, ka hoʻohana ʻana i ka paipu wai, ka nīnau nau a Carter, ka hoʻohana ʻana i ka hāpai keiki, a me ka mōʻaukala menstrual i loaʻa ma ka nānā ʻana i nā palapala like ʻole.Ua kākau ʻia ka nīnau nīnau 26-30 ma ka ʻōlelo Pelekania a unuhi ʻia i ka ʻōlelo kūloko (Afaan Oromoo), a laila unuhi hou ʻia i ka ʻōlelo Pelekania e nā loea ʻōlelo like ʻole e nānā i ke kūlike.E kiʻi i nā ʻikepili lapaʻau e like me ka lōʻihi o ka maʻi maʻi, ke ʻano o ka maʻi maʻi, nā pilikia o ka maʻi maʻi, a me ka hoʻokē ʻai ʻana i nā pae glucose koko mai nā moʻolelo olakino o ka mea maʻi.Ua hōʻiliʻili ʻia ka ʻikepili e nā kahu hānai ʻoihana ʻelua a me kahi ʻenehana ʻenehana, a mālama ʻia e kahi master o ke olakino olakino.
E ana i ke koko (BP) me ka mīkini koko kikohoʻe (Heuer) i hōʻoia mau ʻia.Ma mua o ke ana ʻana i ke koko, ʻaʻole i inu ke kumuhana i nā mea inu wela, e like me ke kī, ke kope a i ʻole ka paka i puhi ʻia, ka nau ʻana i ka ʻuheʻe, a i ʻole ka hana hoʻoikaika kino i nā minuke he 30 i hala.Ma hope o ka hoʻomaha ʻana o ke kumuhana no ka liʻiliʻi ʻelima mau minuke a hoʻopaʻa i ka awelika o ka heluhelu BP, ua lawe ʻia ʻekolu ana kūʻokoʻa ma ka lima hema.Ua lawe ʻia nā ana ʻelua a me ke kolu i ʻelima a me ʻumi mau minuke ma hope o ke ana mua a me ka lua.Ua wehewehe ʻia ke kiʻekiʻe kiʻekiʻe e like me nā poʻe maʻi me ka BP kiʻekiʻe (SBP≥140 a i ʻole DBP≥90mmHg) a i ʻole ka poʻe i ʻike mua ʻia e lawe ana i nā lāʻau antihypertensive.31,32
No ka hoʻoholo ʻana i ke kūlana meaʻai ma o ka helu kino kino (BMI), ua ana mākou i ke kiʻekiʻe a me ke kaumaha o ka mea maʻi.Ke kū pololei kēlā me kēia hui ma ka paia, pili ko lākou mau kuʻekuʻe wāwae i ka paia, ʻaʻole i komo i nā kāmaʻa, mālama pono i ko lākou mau poʻo i luna, a ana i ko lākou kiʻekiʻe me kahi lula a hoʻopaʻa i ka 0.1 knm kokoke loa.E hoʻohana i ka unahi kikohoʻe i kaha ʻia 0-130 kg e ana i kou kaumaha.Ma mua o kēlā me kēia ana, e calibrate i ka pālākiō i ka pae ʻole.E ana i ke kaumaha o ka mea komo i ke komo ana i na lole mama a me na kamaa ole, a e kakau i ka 0.1 kg kokoke loa.33,34 Ua helu ʻia ka helu helu kino (BMI) ma ka puʻunaue ʻana i ke kaumaha o ke kino (kg) me ke kiʻekiʻe (m).A laila ua wehewehe ʻia ke kūlana meaʻai: inā BMI <18.5, underweight;inā BMI = 18.5–24.9, emi ke kaumaha;inā BMI = 25–29.9, ke kaumaha;ina BMI ≥30.35,36, obesity
Ma kahi kokoke i ka lae waena ma waena o ka ʻaoʻao lalo o nā iwi ʻaoʻao i ʻike ʻia a me ka piko o ka hopena, e hoʻohana i kahi ana lipine non-elastic e ana i ka ʻapo o ka pūhaka a hoʻopaʻa i ka 0.1 knm kokoke loa.Ua wehewehe ʻia ka momona waena e like me ka paepae o ka pūhaka no nā kāne ≥ 94 knm, a me ka paepae o ka pūhaka no nā wahine ≥ 80 cm.30,36 I ka wā hoʻomaʻamaʻa, 10 mau maʻi maʻi maʻi maʻi maʻi i hoʻopaʻa ʻia i ka hewa ana ʻenehana pili (%TEM) e hōʻemi i nā hewa ana anthropometric.ʻO nā hewa ana ʻenehana pili i ʻike ʻia i loko a ma waena o nā mea nānā ma lalo o 1.5% a emi ma lalo o 2%, kēlā me kēia.
Ua hōʻiliʻili nā ʻenehana hale hana ma kahi o ʻelua milliliters (2 mL) o nā laʻana koko mai nā mea a pau i komo a waiho ʻia i loko o kahi paipu hoʻāʻo me ka tripotassium ethylenediaminetetraacetic acid (EDTA K3) anticoagulant no ka hoʻoholo ʻana i ka hemoglobin.Hoʻohui pono i ke koko holoʻokoʻa i hōʻiliʻili ʻia a hoʻohana i ka Sysmex XN-550 hematology analyzer no ka nānā ʻana.Ua hoʻoponopono ʻia ke ana o ka hemoglobin ma o ka hoʻemi ʻana i ke kiʻekiʻe o nā mea komo āpau ma ka unuhi ʻana i ka 0.8 g/dl a me ke kūlana puhi paka ma ka unuhi ʻana i ka 0.03 g/dl.A laila e wehewehe i ka anemia ma ke ʻano he pae hemoglobin wahine <12g/dl a he kāne <13g/dl.Hoʻokaʻawale ʻia ka paʻakikī o ka anemia: ʻo ka pae hemoglobin o nā kāne a me nā wahine he 11–12.9 g/dl a me 11–11.9 g/dl, ʻo ia hoʻi, he anemia haʻahaʻa, aʻo nā pae hemoglobin o ka anemia haʻahaʻa a me ka nui he 8-10.9 g/dl, kēlā me kēia dl a me <8 mg/dl.Kane a wahine
E hōʻiliʻili i ʻelima mililita (5 mL) o ke koko venous i loko o kahi paipu hoʻāʻo ʻole me ka anticoagulant e hoʻoholo ai i ka creatinine a me ka urea.Hoʻopili ʻia ke koko holoʻokoʻa me ka anticoagulant no 20-30 mau minuke a centrifuged ma 3000 rpm no 5 mau minuke e hoʻokaʻawale i ka serum.A laila, ua hoʻohana ʻia ka mea anana kemika kemika ʻo Mindray BS-200E (China Mindray Biomedical Electronics Co., Ltd.) no ka hoʻoholo ʻana i ka serum creatinine a me ka urea ma o ka picrine acid a me nā ʻano enzymatic.37 E hoʻohana i ka helu hoʻomaʻemaʻe creatinine no ka hoʻohālikelike ʻana i ka nui o ka kānana glomerular.E hoʻohana i ka maʻi maʻi maʻi maʻi (CKD) ratio (GFR), i hōʻike ʻia e like me ka CKD-EPI Cockroft-Gault formula i hōʻike ʻia no 1.73 square meters.
Ana ʻia ke kiʻekiʻe o ka glucose koko hoʻokēʻai (ma ka liʻiliʻi he 8 mau hola) e nā manamana lima me ka hoʻohana ʻana i kahi mika glucose koko i hoʻopaʻa ʻia no ka glucose koko.38 Inā he <80 a i ʻole> 130mg/dl ke kiʻekiʻe o ka glucose koko hoʻokēʻai, a laila, ʻaʻole i hoʻomalu ʻia ke code i ka mana glucose koko.E hoʻomalu i ka wā ʻoi aku ka nui o ka glucose koko hoʻokēʻai ma waena o 80-130mg/dl 39
Hāʻawi ʻia ka poʻe i komo i ke aʻo ʻana i kahi lāʻau applicator lāʻau maʻemaʻe a me kahi kīʻaha plastik maʻemaʻe, maloʻo a me ka leak-proof me ka helu serial o ke kumuhana no ka nānā ʻana i nā fecal parasite.E aʻo iā lākou e lawe mai i kahi laʻana o ka pahu hou o ʻelua kalama (e like me ka nui o ka manamana lima).Ma hope o ka ʻike ʻana i nā ilo (nā hua manu a/a i ʻole nā ​​larvae) me ka hoʻohana ʻana i nā ʻenehana kau ʻana i ka pulu pololei, ua nānā ʻia nā laʻana i loko o 30 mau minuke o ka hōʻiliʻili ʻana.Ua mālama ʻia nā mea i koe i loko o kahi pahu hoʻāʻo i loaʻa ka 10 mL o 10% formalin no ka hoʻomaikaʻi ʻana i ka helu ʻike ʻana o nā parasites, a ma hope o ka mālama ʻana me ka ʻenehana noʻonoʻo noʻonoʻo formalin-ether, ua hoʻohana ʻia ka Olympus Microscope no ka nānā ʻana.
E hoʻohana i ka lancet sterile e hōʻiliʻili i nā laʻana koko capillary mai nā manamana lima e ʻike ai i ka maʻi maʻi.E hoʻomākaukau i kahi kiʻi koko lahilahi ma ke aniani maʻemaʻe like me ka ʻole o ka momona, a laila maloʻo ka ea.Ua hoʻopaʻa ʻia nā paheʻe me 10% Giemsa no kahi o 10 mau minuke, a ua nānā ʻia nā ʻano maʻi malaria.I ka nānā ʻia ʻana o nā kahua mana kiʻekiʻe he 100 ma lalo o kahi pahuhopu immersion aila, ua manaʻo ʻia ka paheʻe he maikaʻi ʻole.40
Hāʻawi ʻia ka hoʻomaʻamaʻa ʻana i ʻelua lā i nā mea hana hōʻiliʻili ʻikepili a me nā ʻano hana i nā mea hōʻiliʻili ʻikepili a me nā luna.Ma mua o ka hōʻiliʻili ʻana o ka Halemai Nui o Chiro i ka ʻikepili maoli o nā maʻi maʻi diabetic 30, ua hoʻāʻo mua ʻia ka nīnau nīnau a ua hana ʻia nā hoʻololi kūpono e like me ia.Hoʻohālikelike ʻia ke ana kino e ka hewa ʻenehana pili o ke ana (%TEM).Eia kekahi, ua hahai ʻia nā kaʻina hana maʻamau i nā ʻohi hōʻailona hōʻailona a pau, ka mālama ʻana, ka nānā ʻana a me ka hoʻopaʻa ʻana.
Ua loaʻa ka ʻae etika mai ka Institutional Health Research Ethics Review Committee (IHRERC) o ke kula mua o ke ola olakino a me ka lāʻau lapaʻau o Am Valley University (IHRERC 115/2020).Ua hoʻopuka ke kulanui i kahi leka kākoʻo iā GGH a loaʻa ka ʻae mai ke poʻo o ka haukapila.Ma mua o ka hōʻiliʻili ʻana i ka ʻikepili, e kiʻi i ka ʻae ʻike, ʻoluʻolu, kākau a pūlima ʻia mai kēlā me kēia haumāna.Ua haʻi ʻia ka poʻe i komo e hūnā ʻia nā ʻikepili a pau i hōʻiliʻili ʻia mai iā lākou ma o ka hoʻohana ʻana i nā code, ʻaʻole hoʻohana ʻia nā mea hōʻike pilikino, a e hoʻohana wale ʻia no nā kumu noiʻi.Ua mālama ʻia kēia noiʻi e like me ka "Declaration of Helsinki".
E nānā i ka pono o ka ʻikepili i hōʻiliʻili ʻia, hoʻopili a hoʻokomo i ka mana EpiData 3.1, a laila e hoʻokuʻu aku i ka mana STATA 16.0 no ka hoʻokele ʻikepili a me ka nānā ʻana.E hoʻohana i nā pākēneka, nā ʻāpana, nā awelika, a me nā ʻokoʻa maʻamau e wehewehe i ka ʻikepili.Ma hope o ka hoʻoponopono ʻana i ka pae hemoglobin e like me ke kūlana puhi o ka poʻe i komo a me ke kiʻekiʻe o ka wahi, ua hoʻoholo ʻia ke kūlana anemia e like me ke kūlana hoʻohālikelike hou o WHO.E hoʻopili i kahi ʻano hoʻohālikelike loiloi loiloi ʻelua e ʻike ai i nā mea hoʻololi no ka loiloi loiloi logistic multivariate hope loa.I loko o ka bivariate logistic regression, nā mea hoʻololi me ka p-value ≤ 0.25 i manaʻo ʻia he mau moho no ka multivariate logistic regression.E hoʻokumu i ka multivariate logistic regression model e ʻike i nā mea pili ʻole i ka anemia.E hoʻohana i ka ratio odds a me 95% i ka manawa hilinaʻi e ana i ka ikaika o ka hui.Ua hōʻike ʻia ka pae koʻikoʻi helu he p-waiwai <0.05.
Ma kēia noiʻi ʻana, he 325 mau maʻi maʻi DM makua i komo i ka hālāwai, a ʻo 98.2% ka pane pane.ʻO ka hapa nui o nā mea komo;ʻO nā kāne mai nā kuaʻāina he 203 (62.5%), 247 (76%), 204 (62.8%) a me 279 (85.5%) he kāne male, a ʻo kā lākou lāhui ʻo Oromo.ʻO ka makahiki waena o ka poʻe i komo he 40 mau makahiki, a ʻo ka interquartile range (IQR) he 20 mau makahiki.Ma kahi o 62% o ka poʻe i komo ʻaʻole i loaʻa ka hoʻonaʻauao kūlana, a ʻo 52.6% o ka poʻe i komo he poʻe mahiʻai ʻoihana (Papa 1).
Papa 1 Nā hiʻohiʻona socio-demographic o nā poʻe maʻi DM makua i mālama ʻia i loko o kahi haukapila ma ka hikina ʻAitiopa i 2020 (N = 325)
Ma waena o ka poʻe i komo i ke aʻo ʻana, ua hōʻike ʻo 74 (22.8%) ua puhi lākou i hoʻokahi manawa i ko lākou ola ʻana, ke hoʻohālikelike ʻia me 13 mau mea puhi puhi i kēia manawa (4%).Eia kekahi, 12 poʻe (3.7%) ka poʻe inu i kēia manawa, a ʻo 64.3% o nā mea noiʻi he kī ʻeleʻele.ʻOi aku ma mua o ka hapakolu (68.3%) o ka poʻe i komo i ke aʻo ʻana i hōʻike e inu mau lākou i ka kofe ma hope o ka ʻai.Hoʻokahi haneli kanakolukumamākolu (96.3%) a me 310 (95.4%) i ʻai i nā huaʻai a me nā mea kanu ma lalo o ʻelima mau manawa o ka pule.E pili ana i ko lākou kūlana meaʻai, 92 (28.3%) a me 164 (50.5%) poʻe i komo i ke kaumaha a me ka momona ma waena (Table 2).
Papa 2 Nā hiʻohiʻona a me nā meaʻai o nā maʻi DM makua i mālama ʻia ma ka Halemai Nui ʻAitiopa Hikina ma 2020 (N = 325)
ʻOi aku ma mua o 170 (52.3%) mau maʻi me ke ʻano II DM i ka awelika DM lōʻihi o 4.5 (SD±4.0) makahiki.Ma kahi kokoke i 50% o ka poʻe maʻi DM e lawe ana i nā lāʻau hypoglycemic waha (glibenclamide a/a i ʻole metformin), a kokoke i ʻekolu hapaha o ka poʻe i komo i ke aʻo ʻana i hoʻopaʻa ʻole ʻia ka glucose koko (Table 3).E pili ana i nā comorbidities, 2% o nā mea komo i loaʻa i nā comorbidities.ʻO 80 (24.6%) a me 173 (53.2%) nā mea maʻi me DM me ke kiʻekiʻe ʻole he anemia a me ka anemia ʻole.Ma ka ʻaoʻao ʻē aʻe, ma waena o nā maʻi DM i ʻike ʻia me ka hypertension, ʻo 189 (5.5%) a me 54 (16.6%) he anemia.
Papa 3 Nā hiʻohiʻona maʻi o nā maʻi maʻi DM makua i mālama ʻia i loko o kahi haukapila ma ka hikina ʻAitiopa i 2020 (N = 325)
ʻO ke kiʻekiʻe o ka anemia i nā maʻi maʻi maʻi he 30.2% (95% CI: 25.4-35.4%), a ʻo ka pae hemoglobin awelika he 13.2±2.3g/dl (kāne: 13.4±2.3g/dl, wahine: 12.9±1.7g/ dl).E pili ana i ke koʻikoʻi o ka maʻi anemia i nā poʻe maʻi DM me ka anemia, aia he 64 mau hihia o ka anemia haʻahaʻa (65.3%), 26 mau hihia o ka anemia haʻahaʻa (26.5%), a me 8 mau hihia o ka anemia koʻikoʻi (8.2%).ʻO ka anemia i loko o nā kāne (36.0%) iʻoi aku ka kiʻekiʻe ma mua o nā wāhine (20.5%) (p = 0.003) (Figure 1).Ua loaʻa iā mākou kahi pilina maikaʻi ma waena o ka paʻakikī o ka anemia a me ka lōʻihi o ka maʻi diabetes (r = 0.1556, p = 0.0049).ʻO ia ke ʻano o ka piʻi ʻana o ka lōʻihi o ka DM, piʻi ka paʻakikī o ka anemia.
Kiʻi 1 He kiʻekiʻe Anemia ma ke kāne o nā poʻe maʻi DM makua i mālama ʻia i loko o kahi haukapila ma ka hikina ʻAitiopa i 2020 (N = 325)
Ma waena o nā maʻi maʻi DM, ʻo 64% o nā kāne a me 79.5% o nā wahine ʻaʻole i anemic, aʻo 28.7% a me 71.3% o nā Khat chewers i kēia manawa he anemic.ʻO 67% o nā poʻe maʻi DM makua nāna i hoʻohana i ka kofe ma hope o ka ʻai ʻana, ʻaʻole i anemia, a ʻo 32.9% o lākou i loaʻa i ka anemia.E pili ana i ka noho ʻana o nā maʻi maʻi, 72.2% o nā maʻi me ka DM me ka ʻole o ka maʻi maʻi he anemia, a ʻo 36.3% o nā maʻi me nā maʻi maʻi DM he anemia.ʻO ka poʻe maʻi maʻi maʻi me nā pilikia DM i ʻoi aku ka kiʻekiʻe o ka anemia (47.4%) ma mua o ka poʻe me ka pilikia ʻole o ka DM (24.9%) (Table 4).
Papa 4 Nā mea e pili ana i ka anemia ma waena o nā poʻe maʻi DM makua i mālama ʻia i loko o kahi haukapila ma ka hikina ʻAitiopa i 2020 (N = 325)
Hoʻopili i nā kumu hoʻohālike logistic bivariate a me multivariate e nānā i ka pilina ma waena o ka anemia a me nā ʻano wehewehe wehewehe.I loko o ka bivariate analysis;makahiki, ke kāne, ke kūlana male, Khat chewing, kope ma hope o kaʻai, comorbidities, diabetic complications, DM lōʻihi a me ka meaʻai kūlana (BMI) pili loa i ka anemia me ka p waiwai <0.25, a he Multivariate moho logistic regression.
I loko o ka multivariate logistic regression analysis, nā kāne me ka DM ≥ 5 mau makahiki o ka lōʻihi, ka hele ʻana o nā comorbidities a me nā hoʻopiʻi o DM i pili nui me ka anemia.ʻO nā maʻi maʻi DM makua kāne he 2.1 mau manawa e loaʻa i ka anemia ma mua o nā wahine (AOR = 2.1, 95% CI: 1.2, 3.8).Ke hoʻohālikelikeʻia me nā maʻi DM me ka loaʻaʻole o nā maʻi,ʻo nā maʻi DM me nā maʻi maʻi he 1.9 ka nui o ka anemia (AOR = 1.9, 95% CI: 1.0, 3.7).Ke hoʻohālikelike ʻia me nā maʻi me ka lōʻihi o DM o 1-5 mau makahiki, ʻo nā maʻi maʻi me ka lōʻihi o DM ≥ 5 mau makahiki he 1.8 mau manawa e ulu ai ka anemia (AOR = 1.8, 95% CI: 1.1, 3.3).ʻO ka pilikia o ka anemia i nā maʻi me nā pilikia DM he 2.3 mau manawa i ko nā hoa hana (AOR = 2.3, 95% CI: 1.3, 4.2) (Table 4).
Ua loiloi kēia haʻawina i ka paʻakikī o ka anemia a me nā mea pili i nā maʻi maʻi DM i ukali ʻia no ka maʻi diabetes ma Gelemso General Hospital.ʻO ke kiʻekiʻe o ka anemia i ka haʻawina o kēia manawa he 30.2%.Wahi a ka WHO no ka hoʻohālikelike ʻana i ke koʻikoʻi o ke olakino lehulehu, i ka ʻimi noiʻi, ʻo ka anemia he pilikia olakino olakino ma waena o nā poʻe maʻi me DM.ʻO ke kāne, ka lōʻihi o ka DM, ka hiki ʻana o nā pilikia DM, a me nā kāne me nā maʻi maʻi DM i ʻike ʻia he mau mea pili i ka anemia.
ʻO ke kiʻekiʻe o ka anemia ma kēia haʻawina e hoʻohālikelike ʻia me ka Halemai Hōʻikeʻike ʻo Ethiopian Dessie [24], akā ʻoi aku ka kiʻekiʻe ma mua o ka Halemai Fenote Selam ʻAitiopa [41] ma kahi noiʻi kūloko i hana ʻia ma Kina, 42 Australia, 43 a me India [44] ]., ʻO ia ka mea haʻahaʻa ma mua o nā haʻawina i hana ʻia ma Thailand [45], Saudi Arabia [46] a me Cameroon [47].ʻO kēia ʻokoʻa paha ma muli o ka ʻokoʻa makahiki o ka heluna kanaka noiʻi.No ka laʻana, ʻaʻole e like me ka noiʻi o kēia manawa ʻaʻole i hoʻokomo i nā pākeke ma luna o 18 mau makahiki, ʻo kahi haʻawina ma Thailand e pili ana i nā pākeke ma mua o 60 mau makahiki, ʻoiai ʻo kahi haʻawina ma Cameroon e pili ana i nā pākeke ma luna o 50 mau makahiki.ʻO ka ʻokoʻa ma muli paha o ka emi ʻana o ka hana ʻana o ka puʻupaʻa, ka ʻaʻa, ka hoʻopau ʻana i ka iwi iwi, a me ka ʻai ʻole (e piʻi ana me ka makahiki)17.
Pīhoihoi mākou i kā mākou noiʻi ʻana, ʻoi aku ka maʻamau o ka anemia kāne ma mua o ka wahine.He kūʻē kēia ʻike i nā hōʻike noiʻi ʻē aʻe [42,48], kahi e loaʻa ai nā wahine i ka anemia ma mua o nā kāne me ka maʻi diabetes.ʻO ke kumu paha o kēia ʻokoʻa, ʻo ia ka mea ʻoi aku ka nui o ka nau ʻana o ka Khat i nā kāne i kā mākou noiʻi ʻana, kahi e nalowale ai ka ʻai49, a loaʻa i ka Khat nā tannins-he mea e hōʻemi ai i ka bioavailability o ka hao non-heme i ka ʻai.50 ʻO kekahi kumu ʻē aʻe, ʻo ka ʻai nui ʻana o ke kofe a me ke kī i nā kāne i loko o kēia haʻawina ua keʻakeʻa i ka komo ʻana o ka hao mai ka ʻōpū.51-54
Ua ʻike mākou ʻoi aku ka nui o nā maʻi me DM ≥ 5 mau makahiki e hoʻomohala i ka anemia ma mua o nā maʻi me DM me kahi papa o 1-5 mau makahiki.Kūlike kēia me nā haʻawina i mālama ʻia ma ka Halemai Fenote Selam ma ʻAitiopa, 41 Iraq 55 a me United Kingdom.17 No ka lōʻihi o ka loaʻa ʻana o ka hyperglycemia, e alakaʻi ana i ka piʻi ʻana o nā cytokine inflammatory me nā hopena anti-erythropoietin, e hopena i ka emi ʻana o ka helu.ʻO ka emi ʻana o ke kahe koko ʻulaʻula e alakaʻi i ka emi ʻana o ka hemoglobin kaʻa.35
Kūlike me nā haʻawina i hana ʻia ma Kina, ʻo 13 anemia i kēia haʻawina i ʻoi aku ka maʻamau i nā poʻe maʻi DM me nā pilikia.Ma ke ʻano biologically, hiki i nā hoʻopiʻi maʻi maʻi ke hōʻino nui i ke kino a me ka hoʻokumu ʻana o ke kīʻaha koko o ka puʻupaʻa, ka ʻāʻī ʻōnaehana, a me ka hoʻokomo ʻana o nā mea hoʻokuʻu erythropoietin hiki ke alakaʻi i ka anemia diabetic.56 Hiki i ka Hypoxia ke ho'opili i ka hō'ike gene, metabolism, capillary permeability a me ke ola o ka cell 57. Hiki ke ho'emi 'ia ke koko 'ula'ula a me kona mau waiwai antioxidant e pili ana me ka anemia.
Eia kekahi, ʻoi aku ka maʻi o ka maʻi DM me nā maʻi maʻi i ka anemia ma mua o ka poʻe maʻi DM me ka ʻole o nā comorbidities.Hoʻohālikelike kēia i nā haʻawina like mua [35,59], ma muli paha o ka hopena o nā comorbidities (e like me ka hypertension) e alakaʻi ana i nā pilikia cardiovascular, a laila e hoʻonui ai i ka pilikia o ka anemia.60
E like me kekahi o nā haʻawina liʻiliʻi loa i hana ʻia ma ʻAitiopia, ua lilo nā maʻi maʻi e like me DM i mea maʻamau, ʻo ia ka ikaika o kēia noiʻi.Ma ka ʻaoʻao ʻē aʻe, he haʻawina hoʻokahi kēia haʻawina e pili ana i kahi haukapila a ʻaʻole paha e hōʻike i nā maʻi āpau me DM a i ʻole nā ​​​​maʻi i ukali ʻia ma nā keʻena olakino ʻē aʻe.ʻAʻole ʻae ke ʻano cross-sectional o ka hoʻolālā haʻawina a mākou i hoʻohana ai i ka hoʻokumu ʻana i nā pilina kino ma waena o ka anemia a me nā kumu.Pono paha nā haʻawina e hiki mai ana e hoʻohana i nā mana hihia, nā noiʻi cohort a i ʻole nā ​​hoʻolālā noiʻi ʻē aʻe e noʻonoʻo ai i nā hōʻailona a me nā hōʻailona o ka anemia, RBC morphology, serum iron, vitamin B12, a me nā pae waikawa folic.
I loko o ka ʻimi noiʻi, ʻo ka anemia he pilikia olakino olakino ma waena o nā poʻe maʻi DM makua.ʻO ke kāne, ka lōʻihi o ka DM, ka hiki ʻana o nā pilikia DM, a me nā comorbidities he kāne a ua ʻike ʻia he mau mea pili i ka anemia.No laila, pono e hoʻolālā ʻia ka nānā ʻana i ka anemia maʻamau a me ka hoʻokele kūpono no ka poʻe maʻi DM me ka lōʻihi o ka DM, nā comorbidities a me nā pilikia e hoʻolālā e hoʻomaikaʻi i ka maikaʻi o ke ola o nā maʻi.ʻO ka ʻike mua ʻana a me ka nānā mau ʻana i ka DM hiki ke kōkua i ka hōʻemi ʻana i nā pilikia.
Hiki ke loaʻa nā ʻikepili e kākoʻo ana i nā hopena i hōʻike ʻia ma ka palapala mai ka mea kākau pili e like me nā koi kūpono.
Makemake mākou e hoʻomaikaʻi i ke poʻo o ka Halemai Nui o Gelemso, nā limahana o ka Diabetes Clinic, nā mea noiʻi, nā ʻohi ʻikepili a me nā mea kōkua noiʻi.
Ua hāʻawi nui nā mea kākau a pau i ka hana o ka hōʻike, inā ma ke ʻano o ka manaʻo, ka hoʻolālā noiʻi, ka hoʻokō, ka loaʻa ʻana o ka ʻikepili, ka nānā ʻana a me ka wehewehe ʻana, a i ʻole ma kēia mau ʻano a pau;i komo i ka hoʻolālā, hoʻoponopono ʻana a i ʻole ka loiloi ikaika o kēia māhele;Ua ʻae ʻia ka mana e paʻi ʻia;i ʻaelike ma ka puke pai i waiho ʻia ai ka ʻatikala;a ua ʻae ʻo ia ke kuleana no nā ʻano āpau o ka hana.
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