2型糖尿病住院患者糖尿病肾脏疾病的发生率及危险因素分析

目的：分析2型糖尿病住院患者的糖尿病肾脏疾病（DKD）的发生率及危险因素,为临床糖尿病肾脏疾病的防治工作提供理论依据。方法：对2008年1月～2010年8月在上海交通大学附属第六人民医院内分泌代谢科住院的2型糖尿病患者测定血糖、肾功能、血脂谱、24h尿白蛋白等。应用简化肾脏病膳食改良试验（MDRD）公式计算肾小球滤过率（GFRMDRD）。所有患者均由眼科医生进行眼底摄片。按2007年美国肾脏病基金会（NKF）的糖尿病和慢性肾脏疾病的临床诊断治疗指南,将研究人群分为正常组（NCKD）、非糖尿病性肾脏疾病（NDRD）组及DKD组。结果：（1）共入选患者2225例,男1184例,女1041例;平均年龄为（60.5±11.7）岁。本研究人群中,DKD的发生率为15.4%,NDRD的发生率为18.5%。（2）DKD组患者的年龄、糖尿病病程、收缩压、血肌酐、总胆固醇（TC）、低密度胆固醇水平（LDL-C）、24h尿白蛋白量均显著高于NDRD组（P〈0.05）。（3）Logistic回归分析显示：糖尿病病程（OR=1.077,95%CI为1.059～1.096,P〈0.01）、收缩压（OR=1.039,95%CI为1.032～1.047,P〈0.01）、糖化血红蛋白（OR=1.092,95%CI为1.032～1.156,P〈0.01）、TC（OR=1.171,95%CI为1.050～1.306,P〈0.01）、HDL-C（OR=0.558,95%CI为0.369～0.844,P〈0.01）是DKD发生的独立危险因素。结论：为有效地延缓2型糖尿病肾脏病变的发生及发展,临床工作中要严格控制血压、血糖、血脂。     

中国2型糖尿病危险因素分析

目的;分析我国2型糖尿病发病的危险因素,为糖尿病的预防和治疗提供依据。方法：利用自然人群,采取分层随机抽样,直接测OGTT服糖后2h血糖的方法诊断糖尿病和糖耐量损害,采用多元回归法进行分析。结果：在年龄大于40岁,具有糖尿病家族史,体质指数25以上和腰臀比0．9以上及吸烟人群中,糖尿病及糖耐量损害患病率剧增。高血压人群中糖尿病及糖耐量损害的发生率显著高于非高血压人群。结论：年龄增大、阳性家族史,高腰臀比,体力活动量少,体质指数大及嗜好吸烟,是糖尿病及糖耐量损害的危险因子。2型糖尿病与高血压关系密切。     

2型糖尿病患者微量白蛋白尿危险因素分析

目的：研究2型糖尿病微量白蛋白尿（MAU）的危险因素。方法：对47例2型糖尿病合并MAU的患者和56例2型糖尿病非合并MAU的患者的病程、年龄、血脂、血糖、血压、空腹胰岛素（FINS）和空腹C肽（F-CP）水平等因素进行分析比较，同时将微量白蛋白排泄率（UAER）与各指标进行相关分析和多元逐步回归分析。结果：2型糖尿病合并微量白蛋白尿组的、舒张压（DBP）、甘油三酯（TG）、载脂蛋白B(APOB)显著高于非合并微量白蛋白尿组，而高密度脂蛋白（HDL-C）则明显低于后者；UAER与年龄、病程、血压、空腹C肽（F-CP）、糖化血红蛋白（HbAlC）、TG、低密度脂蛋白（LDL-C）、APOB呈正相关，与HDL-C呈负相关；经多元逐步回归分析后得出：UAER与HbAlC、F-CP、TG、SBP、病程、APOB呈正相关，与HDL-C呈负相关。结论：2型糖尿病的病程长和以高TG、高APOB和低HDL为特征的脂代谢紊乱是糖尿病肾病的危险因素，高血压、HbAlC、高F-CP水平也是糖尿病的危险因子。     

2型糖尿病患者心血管并发症相关危险因素分析

目的:探讨2型糖尿病患者心血管并发症的相关危险因素,为干预治疗提供医学依据。方法:90例2型糖尿病患者分为无心血管并发症组56例(A组)和心血管并发症组34例(B组),同时选取60例体检人员作为正常组,比较三组的相关临床及生化指标。结果:A、B两组HbA1c、FBG、TG、CRP、UA、HCY、HDL-C、BMI、收缩压及舒张压相关指标较正常组存在统计学差异,且B组较A组CRP、UA、HCY和收缩压显著增高,Logi st i回c归分析显示T2DM心血管并发症的发生与CRP、UA、HCY和收缩压密切相关。结论:高CRP、高UA、高HCY和高收缩压是T2DM发生心血管并发症的独立危险因素。     

2型糖尿病患者勃起功能障碍危险因素分析

阴茎勃起功能障碍（erectile dysfunction，ED）是糖尿病的常见并发症。糖尿病患者的ED较其他人群起病早，患病率高，与其他糖尿病并发症相比，未引起广大内分泌科医生足够的重视，患者亦很少得到充分的治疗，尤其是对糖尿病性ED发病的危险因素尚不清楚。本文旨在分析糖尿病ED的发生率及其影响因素，以利于及早干预治疗，从而预防糖尿病性ED的发生。     

中国丹东地区2型糖尿病患者骨质疏松症相关危险因素分析

目的分析丹东地区2型糖尿病（T2DM)患者骨质疏松症（0P)情况及骨质疏松症相关危险因 素。方法测定232例T2DM患者腰椎及股骨颈（晕藻糟噪）骨密度（BMD ),根据1998年WHO制定的 0P诊断标准把T2DM患者分为OP组与非OP组,比较两组生化指标、BMD差异,并进行相关性分析。结果1. T2DM患者中0P组与非0P组之间生化资料比较示0P组低密度脂蛋白（LDL-C )较非0P 组明显高,存在显著性差异（孕<0.05 )。2.0P组与非0P组腰椎（L1-4 )BMD比较示两组之间无显著 性差异（P >0. 05 );0P组的总体、男性及女性的平均股骨颈（Neck )BMD明显低于非0P组,两组之间 存在显著性差异（P <0.05 )。3. T2DM患者中0P组65例,总体发病率28.0%.( 65/232 ),其中男性8 例,男性发病率12.5%( 8/64 );女性57例,女性发病率33.9%( 57/168 ),男女0P发病率比较,存在 显著性差异(f越10.552,<0. 05 )。4. LogisLic回归分析示：T2DM患者中女性、有微血管并发症（糖 尿病肾病或/和糖尿病视网膜病变）、有高血压、血清钙离子低、低体重指数与0P发生相关（P <0.05 )。结论1.丹东地区住院T2DM患者的0P发病率28.0%.,明显高于正常人群,且女性发病率 高于男性。2.丹东地区T2DM患者中女性、有微血管并发症（糖尿病肾病或/和糖尿病视网膜病变）、有高血压、血清钙离子低、低体重指数与0P发生相关。     

2型糖尿病合并胆囊结石的相关危险因素

目的 探讨2型糖尿病患者发生胆囊结石的相关危险因素.方法 回顾性分析2007年1月至2010年5月北京协和医院体检中心2574例2型糖尿病患者的临床资料,对其中429例2型糖尿病合并胆囊结石患者(研究组)和2145例2型糖尿病不合并胆囊结石患者(对照组),按照年龄、性别进行1∶5配比以进行病例对照研究.计数资料采用x2检验,对收缩压(SBP)、舒张压(DBP)、空腹血糖(FBG)、TC、TG、高密度脂蛋白胆固醇(HDL-CH)、低密度脂蛋白胆固醇(LDL-CH)和体质指数(BMI)等相关危险因素进行单因素分析,采用四格表x2检验筛选出有统计学意义的可疑危险因素,再对这些可疑因素进行多因素Logistic回归分析.结果 单因素分析结果显示在SBP、FBG、TC、HDL-CH及BMI 5个方面,研究组与对照组比较,差异有统计学意义(x2=20.323,4.365,4.028,7.049,7.319,P＜0.05).去除年龄、性别的影响后,多因素分析结果证实SBP、TC、HDL-CH及BMI是2型糖尿病合并胆囊结石患者的危险因素(x2=18.047,6.905,12.884,7.557,P＜0.05).结论 BMI、SBP和TC水平增高及HDL-CH浓度降低可能是2型糖尿病合并胆囊结石的危险因素.

Abstract：

Objective To explore risk factors for type 2 diabetes mellitus complicated with gallstone disease. Methods The clinical data of 429 type 2 diabetes mellitus patients complicated with gallstone disease (case group) and 2145 type 2 diabetes mellitus patients without gallstone disease (control group) were collected from the Health Center of Peking Union Medical College Hospital from January 2007 to May 2010. According to sure (SBP), diastolic blood pressnre (DBP), fasting blood glucose (FBG), total cholesterol (TC), Triglyceride (TG), high-density lipoprotein cholesterol (HDL-CH), low-density lipoprotein cholesterol (LDL-CH) and body mass index (BMI) were statistically analyzed by fourfold table chi-square test or conditional Logistic regression.Results Univariate analysis showed that there was a significant difference in the levels of SBP, FBG, TC, HDL-CH and BMI between the case group and the control group (x2 =20.323, 4.365, 4.028, 7.049, 7.319, P＜0.05). Multivariate analysis confirmed that SBP, TC, HDL-CH and BMI were risk factors for gallstone disease in patients with type 2 diabetes mellitus (x2 = 18. 047, 6. 905, 12. 884, 7. 557, P ＜ 0. 05). Conclusion Increased SBP, TC and BMI and decreased HDL-CH may be the risk factors for type 2 diabetes mellitus complicated with gallstone disease.     

2型糖尿病合并胆囊结石的相关危险因素

Objective To explore risk factors for type 2 diabetes mellitus complicated with gallstone disease. Methods The clinical data of 429 type 2 diabetes mellitus patients complicated with gallstone disease (case group) and 2145 type 2 diabetes mellitus patients without gallstone disease (control group) were collected from the Health Center of Peking Union Medical College Hospital from January 2007 to May 2010. According to sure (SBP), diastolic blood pressnre (DBP), fasting blood glucose (FBG), total cholesterol (TC), Triglyceride (TG), high-density lipoprotein cholesterol (HDL-CH), low-density lipoprotein cholesterol (LDL-CH) and body mass index (BMI) were statistically analyzed by fourfold table chi-square test or conditional Logistic regression.Results Univariate analysis showed that there was a significant difference in the levels of SBP, FBG, TC, HDL-CH and BMI between the case group and the control group (x2 =20.323, 4.365, 4.028, 7.049, 7.319, P＜0.05). Multivariate analysis confirmed that SBP, TC, HDL-CH and BMI were risk factors for gallstone disease in patients with type 2 diabetes mellitus (x2 = 18. 047, 6. 905, 12. 884, 7. 557, P ＜ 0. 05). Conclusion Increased SBP, TC and BMI and decreased HDL-CH may be the risk factors for type 2 diabetes mellitus complicated with gallstone disease.     

2型糖尿病患者发生小腿肌间静脉血栓的危险因素分析

目的:探讨2型糖尿病患者发生小腿肌间静脉血栓的危险因素。方法:回顾性分析2013年6月—2019年6月于济南市中医医院内分泌科及滕州市中医医院内分泌科住院治疗的90例2型糖尿病患者的临床资料,根据发生小腿肌间静脉血栓与否分为血栓组(n=30)与对照组(n=60),对比分析两组患者的性别、年龄、体质量指数、糖尿病病程等临床资料,进行单因素分析,组间比较有显著差异的单因素,代入二元Logistic回归分析进行独立危险因素检验。结果:两组患者在年龄、体质量指数、糖尿病病程、合并糖尿病周围神经病变人数、合并活动性溃疡人数、合并冠心病人数、合并高血压人数、吸烟人数、血糖控制方案、白细胞计数、血小板计数、凝血酶原时间、活化部分促凝血酶原激酶时间、纤维蛋白原、D-二聚体、纤维蛋白原降解产物、红细胞沉降率等方面组间比较差异无统计学意义(P0.05);在性别、合并糖尿病周围血管病变人数、糖化血红蛋白水平、超敏C反应蛋白水平差异有统计学意义(P0.05)。Logistic回归显示,糖化血红蛋白高水平、超敏C反应蛋白高水平为2型糖尿病患者发生小腿肌间静脉血栓的独立危险因素。结论:糖化血红蛋白高水平、超敏C反应蛋白高水平为2型糖尿病患者发生小腿肌间静脉血栓的独立危险因素。     

2型糖尿病患者血清视黄醇结合蛋白4水平及相关影响因素的研究

目的 探讨2型糖尿病（T2DM）患者血清视黄醇结合蛋白4（RBP4）的变化及其相关影响因素。方法根据体重指数（BMI）将80例T2DM患者分为肥胖T2DM组（BMI≥25kg／m^2）、非肥胖T2DM组（BMI〈25kg／m^2）,将30例正常体重非糖尿病者设为对照组。检测其空腹血清脂联素（APN）、RBP4、胰岛素（FINS）水平,同时测定空腹血糖（FBG）、身高、体重、腰围、臀围、糖化血红蛋白（HbA1c）、三酰甘油（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）,计算BMI、腰臀比（WHR）和稳态模式评估法胰岛素抵抗指数（HOMA-IR）。分析各组间RBP4水平的变化,并与上述其他指标进行相关分析。结果RBP4在肥胖T2DM组和非肥胖T2DM组中显著高于对照组[分别为（30．02±5．32）、（20．10±5．45）、（12．02±3．45）mg／L]（P〈0．01）,在肥胖T2DM组显著高于非肥胖T2DM组（P〈0．01）。单因素相关分析显示RBP4与TG、BMI、FBG、WHR、FINS、HOMA．IR呈正相关,与APN呈负相关（相关系数分别为0．225、0．697、0．323、0．557、0．272、0．461、-0．398）。结论血清RBP4在T2DM患者中显著升高,RBP4可能在胰岛素抵抗及T2DM的发生、发展过程中起了重要的作用。     

糖尿病肾脏疾病患者血清三叶因子水平变化的临床意义

目的 探讨糖尿病肾脏疾病（diabetic kidney disease,DKD）患者血清三叶因子（trefoil factor 3,TFF3）水平的变化及其临床意义.方法 依据24 h尿白蛋白排泄率（urine albumin excretion rate,UAER）将123例2型糖尿病（type 2 diabetes mellitus,T2DM）患者分为3组：单纯糖尿病组（SDM组,UAER＜30 mg/24 h）42例;早期糖尿病肾脏疾病组（EDKD组,UAER 30～300 mg/24 h）46例;临床糖尿病肾脏疾病组（CDKD 组,UAER＞300 mg/24 h）35例.另选择健康体检者20名为对照组.用酶联免疫吸附测定（enzyme linked immunosorbent assay,ELISA）检测所有研究对象血清TFF3表达水平,并对相关临床资料进行统计学分析.结果 CDKD组的血清TFF3水平[（71.33±9.48）ng/ml]明显高于其他3组,EDKD组患者血清TFF3水平[（49.31±8.93）ng/ml]显著高于SDM组[（32.65±7.27）ng/ml],而对照组血清TFF3水平最低[（17.65±6.27）ng/ml],各组间比较有统计学差异（P＜0.01）.Pearson相关分析显示,T2DM患者血清TFF3水平与UAER呈正相关（r＝0.897,P＜0.05）.结论 血清TFF3表达水平与DKD的发生、发展呈正相关,可作为预测及判断DKD严重程度的重要指标之一.     

脉动波传导速度在外周血管病预测和诊断中的意义

目的 探讨脉动波传导速度在预测和诊断外周血管病(PAD)中的意义.方法 对国内15个医疗中心,1500例50岁以上2型糖尿病,具有一项或多项心血管疾病相关危险因素的患者,一期同时测定踝肱指数(ABI)和臂踝脉动波传导速度(bapWV).所有患者同时记录血压水平,高血压病程;血糖水平,糖化血红蛋白值,糖尿病病程;血脂水平;体质量指数;吸烟状况;心血管事件和脑血管病的患病情况.对数据进行统计分析.结果 2型糖尿病患者在ABI值正常时,baPWV表现为异常加速,且女性较男性更明显(P<0.01).2型糖尿病患者合并PAD后,ABI降低(右侧0.82±0.15,左侧0.80±0.16),baPWV和非合并PAD患者相比明显减速[右侧(1652.64±428.7)cm/s比(1699.1±316.3)cm/s,左侧(1655.3±477.2)cm/s比(1677.5±338.6)cm/s,P<0.01].ABI、baPWV和年龄、糖尿病病程、高血压等危险因素以及心血管事件间均呈正相关.年龄是PAD的重要危险因素,非PAD患者,baPWV随年龄增大而加速(P<0.01),PAD患者的baPWV则随年龄增加而明显减低(P<0.01).结论 baPWV可以和ABI一起作为PAD筛查和诊断的指标,可能会比ABI更早、更敏感地预测血管病变的存在和发生.     

Critical analysis and limitations of resting ankle-brachial index in the diagnosis of symptomatic peripheral arterial disease patients and the role of diabetes mellitus and chronic kidney disease

BackgroundThe ankle-brachial index (ABI) may underestimate the severity of peripheral arterial disease (PAD) in patients with noncompressible vessels. This study analyzed limitations of the ABI and toe-brachial index (TBI), if done alone, in patients with symptomatic PAD, diagnosed by duplex ultrasound (DUS) examination, particularly in patients with diabetes and chronic kidney disease (CKD).MethodsThis is a retrospective review of prospectively collected data. All patients underwent resting ABIs, TBI, and/or DUS. An ABIs of 0.90 or less in either leg was considered abnormal, and the term inconclusive ABIs (noncompressibility) was used if the ABI was 1.3 or greater. The sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy (OA) of ABIs in detecting 50% or greater stenosis of any arterial segment based on DUS were determined. A TBI of less than 0.7 was considered abnormal.ResultsWe included 2226 ABIs and 1383 DUS examinations: 46% of patients had diabetes, 16% had CKD, and 39% had coronary artery disease. Fifty-three percent of the ABIs were normal, 34% were abnormal, and 13% were inconclusive. For patients with limb-threatening ischemia, 40% had normal ABIs, 40% abnormal ABIs, and 20% were inconclusive. The sensitivity and OA for ABIs in detecting 50% or greater stenosis in the whole series were 57% (95% confidence interval [CI], 53.7-61.2) and 74% (95% CI, 71.9-76.6); for diabetics 51% (95% CI, 46.1-56.3) and 66% (95% CI, 62.3-69.8); nondiabetics 66% (95% CI, 59.9-70.9) and 81% (95% CI, 78.2-83.9). For patients with CKD, the sensitivity and OA for ABIs in detecting 50% or greater stenosis was 43% (95% CI, 34.3-52.7) and 67% (95% CI, 60.2-73.0) versus patients with no CKD 60% (95% CI, 56.3-64.6) and 76% (95% CI, 73.1-78.1). If patients with inconclusive ABIs were excluded, these values were 69% (95% CI, 65.2-72.9) and 80% (95% CI, 77.2-81.9) in the whole series; 67% (95% CI, 61.6-72.7) and 75% (95% CI, 70.5-78.4) for diabetics; and 63% (95% CI, 51.3-73.0) and 78% (95% CI, 70.6-83.9) for patients with CKD. Thirty-three percent of TBIs were normal and 67% were abnormal. The sensitivity and OA for abnormal TBI in detecting 50% or greater stenosis were 85% (95% CI, 78.9-90.0) and 75% (95% CI, 70.1-80.2) in the whole series; 84% (95% CI, 76.0-90.3) and 74% (95% CI, 67.1-80.2) for diabetics; and 77% (95% CI, 61.4-88.2) and 72% (95% CI, 59.9-82.3) for patients with CKD. For those with inconclusive ABIs, these values for TBI were 75% and 69%.ConclusionsOf symptomatic patients with PAD with 50% or greater stenosis on DUS examination, 43% had normal/inconclusive resting ABIs (49% in diabetics and 57% in CKD). TBI may help in patients with inconclusive ABIs. These patients should undergo further imaging to determine proper treatment.     

1242例糖尿病肾脏疾病住院患者初诊时情况及危险因素分析

目的 调查2型糖尿病肾脏疾病(DKD)患者初次诊断时的临床情况,分析DKD预后危险因素,为临床实践提供参考.方法 采用回顾性病例对照研究.收集2003年1月至2008年12月住院期间首次诊断为DKD的1242例患者的临床资料,并随访其预后情况.总结我院DKD患者初诊时的情况,多因素回归分析死亡相关危险因素.结果 1242例初诊时处于Mogensen分期Ⅳ期或Ⅴ期的患者占77.2％,并发心脑血管疾病者占24.8％,其中,36.6％患者Scr ＞176.8 μmol/L.对初诊时为Ⅲ、Ⅳ或Ⅴ期的病例进行单因素方差分析发现,3组间糖尿病病程、血红蛋白、白蛋白、Scr、伴随疾病指数(Charlson指数)差异有统计学意义.Logistic回归分析显示,年龄、白蛋白、Scr、并发心脑血管疾病、Charlson指数均为DKD死亡危险因素(OR值分别为1.057、0.908、1.002、2.006、1.371),而与性别、糖尿病病程、血红蛋白等无相关.上述危险因素在416例未行肾脏替代治疗的随访患者中得到了进一步的验证.多元线性回归分析发现,初诊时的血白蛋白水平与未透析DKD患者存活时间相关(P=0.003).162例未行肾脏替代治疗的患者总体预后差,平均存活时间(距首次住院诊断为DKD)短,为1.2145年.结论 我院DKD患者初诊时机较晚,大部分已处于Ⅳ期或Ⅴ期,且病情重、多并发其他疾病.年龄、白蛋白、Scr、心脑血管疾病、Charlson指数为死亡危险因素,而性别、糖尿病病程、血红蛋白等未显示出统计学意义上的相关性.初诊时白蛋白水平与患者存活时间相关.早期诊断并积极干预DKD相关危险因素对改善患者预后极其重要.     

维持性血液透析患者外周动脉疾病及危险因素分析

目的通过测量踝肱指数调查维持性血液透析患者下肢外周动脉疾病的患病率及危险因素。方法纳入我院血液净化中心179例维持性血液透析患者,对其进行问卷、体格检查、实验室检查及踝肱指数测量。以任何一侧踝肱指数〈0．90作为下肢外周动脉疾病的诊断标准,分析其患病率及危险因素。结果我院血液净化中心下肢外周动脉疾病的患病率为12．8％（23／179）,男女患病率无差异。年龄大于65岁患者外周动脉疾病患病率为18．9％,低于65岁患者为8．6％。高三酰甘油血症患者外周动脉疾病患病率为18．7％,非高三酰甘油血症患者为7．7％。有脑血管疾病患者比无脑血管疾病患者外周动脉疾病患病率高（33．3％：11．3％,P〈0．05）。Logistic分析显示,年龄（优势比为1．036-1．276,P=0．009）、慢性肾脏病病程（优势比1．003～1．018,P=0．007）、脑血管疾病（优势比2-202．19,P=0．011）为外周动脉疾病的独立危险因素。结论维持性血液透析患者外周血管疾病患病率较高,年龄、慢性肾脏病病程及脑血管疾病史为此人群外周血管疾病的独立危险因素。     

彩色多普勒超声诊断2型糖尿病患者下肢动脉病变

目的分析彩色多普勒超声用于诊断2型糖尿病患者下肢动脉病变的价值。方法对800例2型糖尿病患者的3组下肢动脉：胫前动脉（ATA）、胫后动脉（PTA）和足背动脉（DPA）行彩色多普勒超声检查,从管径、斑块及血流动力学方面进行比较。结果糖尿病患者下肢动脉出现斑块最多、狭窄最严重的是ATA远心端和DPA,PTA斑块相对较少,狭窄较轻。糖尿病包括糖尿病足双侧下肢动脉在管径、管腔最大狭窄率及血流动力学方面差异无统计学意义,病变程度相当。结论彩色多普勒超声在诊断糖尿病下肢动脉病变中具有重要价值,有助于了解血管狭窄程度及血流动力学方面的信息,指导临床治疗。     

Classification tree model analysis on related factors of early renal damage in type 2 diabetic patients

Objective To analyze the impact factors for early renal damage in type 2 diabetic patients by the classification tree model. Methods A total of 601 patients with type 2 diabetes were enrolled. According to glomerular filtration rates and urine albumin quantification, the patients were divided into type 2 diabetes group ( 418 cases ) and early diabetic renal damage group ( 183 cases ). The clinical data of the patients were recorded to analyze the main influential factors for the microalbuminuria of type 2 diabetic patients using the Exhaustive CHAID classification tree algorithm. Results Six important explanatory variables were screened out by the classification tree model from the 34 candidate variables related to early renal damage, including fibrinogen, history of hypertension, retinopathy, Cys C levels, SBP and peripheral neuropathy. Elevated fibrinogen was the main factor. Conclusion The classification tree model can analyze the major influential factors of early renal damage in type 2 diabetic patients effectively, and it can help develop the prevention and treatment methods.     

Atherosclerotic cardiovascular disease among patients with type 2 diabetes in Basrah

AIM: To determine the frequency of atherosclerotic cardiovascular disease and its risk factors among patients with type 2 diabetes in Basrah, Iraq.METHODS: Participants in this cross-sectional study were patients who had type 2 diabetes for at least 1 year, presenting at the Al-Faiha Diabetes Endocrine and Metabolism Center in Basrah (Southern Iraq) over the period from January to December 2008.RESULTS: The series included 1079 patients (58.8% men), of whom 25.0% were smokers. The prevalence of symptomatic cardiovascular disease and hypertension was 16.0%, and 44.3% respectively. Those who were overweight or obese constituted 70.5%. Insulin was used in only 26.9% despite 56.1% having had diabetes for 6 years and more. The mean glycated hemoglobin (HbA1c) was 9.46% ± 2.0% and only 5.5% achieved the target of HbA1c of < 7%. We had 68.7% of patients with total cholesterol of ≥ 200 mg/dL, 21.5% with high density lipoprotein cholesterol of < 40 mg/dL, 84.1% with low density lipoprotein cholesterol of ≥ 100 mg/dL and 71.6% with triglyceride of ≥ 150 mg/dL.CONCLUSION: Among adults with type 2 diabetes mellitus, there was increased frequency of cardiovascular disease and its modifiable risk factors. This finding necessitated urgent work to modify these risk factors in a population based setting.     

2型糖尿病合并胆囊结石相关危险因素的研究进展

2型糖尿病引起的胰岛素抵抗、脂代谢紊乱,自主植物神经病变等是形成胆囊结石的高危因素。近年来,对2型糖尿病与胆囊结石相关性的研究有了一些新的进展,如脂联素、瘦素及代谢综合征等等。本文对2型糖尿病合并胆囊结石的相关危险因素进行了总结。