初诊2型糖尿病代谢状态及慢性并发症与肥胖程度的相关性研究

目的探讨初诊2型糖尿病患者代谢状态及慢性并发症与肥胖程度的相关性。方法对我院2009年1月²011年12月期间308例新诊断的T2DM住院患者进行研究,患者根据体重指数进行成组配比病例对照研究,对比三组患者血糖、血压、血脂、空腹C肽水平及并发症发病率行相关性分析。结果低体重患者主要临床特征为胰岛素分泌水平低下,HbA及空腹血糖增高,而微血管并发症以视网膜病变较为突出。超重及肥胖的糖尿病患者主要临床特征表现为高血压、胰岛素抵抗、高甘油三酯及低高密度脂蛋白胆固醇血症,且超重组患者易伴发高血压及冠心病等大血管并发症。结论初诊T2DM的低体重患者需及时补充胰岛素并对视网膜病变并发症重点筛查;而初诊T2DM超重患者应积极进行减肥、降压及调脂等综合治疗。

RELATIONSHIP OF METABOLIC STATUS AND CHRONIC COMPLICATIONS WITH BODY MASS INDEX IN PATIENTS WITH NEWLY DIAGNOSED TYPE 2 DIABETES MELLITUS

Objective The aim of this study was to discuss the relationship of metabolic status and chronic complications with body mass index in patients with newly diagnosed type 2 diabetes mellitus（ T2DM）. Methods 308 patients with T2 DM were collected from 2009- 01 ～ 2011- 12 in our hospital,We categorized the patients into three groups of underweight（BMI 18.5 kg/m2）,normal weight（18.5≤BMI 〈23.0 kg/m2）and overweight（BMI≥ 23.0 kg/m2）,then compared metabolic parameters and prevalence of micro /macro vascular complications among 3 groups. Results Clinical feature of patients with newly diagnosed T2 DM in underweight group were impaired insulin secretion,significantly increased HbA1 c and fasting plasma glucose,and favorable retinal diseases for microvascular complications compared to other groups;meanwhile,patients in over- weight group showed clinical feature of significant insulin resistant,hypertension and coronary heart disease were prone for macrovascular complications. Conclusion In underweight patients with a newly diagnosed T2 DM,it is important to put emphasis on screening for mierovascular complications and initiating insulin therapy earlier; while for the overweight patients,clinicians should pay more attention to reducie weight,decrease blood pressure and improve dyslipidemia and insulin resistance.