2008至2009年本溪市中心城区2型糖尿病患者视网膜病变患病率及相关因素调查

目的 了解本溪市中心城区2型糖尿病患者视网膜病变患病率及相关因素.方法 采用多阶段分层整群抽样方法对2007年12月至2009年5月本溪市中心城区2276例2型糖尿病患者[男1166例,女1110例,年龄31～90岁,平均(61±11)岁]进行分析,行散瞳眼底镜检查或眼底荧光素血管造影,采集临床资料,根据不同危险因素及是否伴有其他并发症分组,比较各组糖尿病视网膜病变的患病率.应用卡方检验进行率的比较,应用多元Logistic回归进行危险因素分析.结果 糖尿病视网膜病变患病率为31.81%.随着患者年龄的增长,糖尿病视网膜病变患病率增高(x~2=25.037,P＜0.05),65岁以上患者糖尿病视网膜病变患病率达37.37%.随着病程的延长,糖尿病视网膜病变患病率增高(x~2=109.873,P＜0.05),病程超过20年的患者糖尿病视网膜病变患病率高达53.81%.吸烟、高血压、血脂异常、糖尿病家族史、高尿酸血症、糖化血红蛋白≥8%、合并冠心病和周围神经病变者糖尿病视网膜病变的患病率较高.饮茶者糖尿病视网膜病变的患病率低于不饮茶者(x~2=9.977,P＜0.05),饮茶者视网膜病变程度低于不饮茶者(x~2=7.267,P＜0.05).结论 高龄、病程延长、吸烟、高血压、血脂异常、糖尿病家族史、高尿酸血症、糖化血红蛋白≥8%、合并冠心病和周尉神经病变均为糖尿病患者视网膜病变的危险因素,而饮茶可延缓糖尿病患者视网膜病变的发生、发展.     

住院2型糖尿病患者合并糖尿病肾脏疾病的危险因素分析

目的分析2型糖尿病患者合并糖尿病肾脏疾病的危险因素。方法选择该院426例住院2型糖尿病患者作为研究对象,将其分为正常组、NDRD组及DKD组,通过比对分析糖尿病患者合并糖尿病肾脏疾病的危险因素。结果DKD组肌酐、尿酸、血红蛋白、白蛋白、总胆固醇、低密度脂蛋白、尿白蛋白量等资料均高于NDRD组,差异有统计学意义(P0.05);糖尿病病程、收缩压、糖化血红蛋白、TC、HDLC均为DKD发生的独立危险因素。结论住院2型糖尿病患者合并糖尿病肾脏疾病主要与多种危险因素有关,通过控制血压、血尿酸、纠正低蛋白血症可以延缓糖尿病肾脏疾病的发生和发展。     

初诊2型糖尿病患者微血管病变的患病率及相关危险因素分析

目的明确北京地区初诊2型糖尿病患者微血管病变(外周神经病变,视网膜病变,糖尿病肾病)的患病率,并对其相关危险因素进行分析。方法对402例新诊断的2型糖尿病患者进行眼底荧光造影和尿微量白蛋白、神经传导速度及相关指标测定,计算微血管病变的患病率,并对相关因素行Logistic回归分析。结果(1)初诊糖尿病的患者中糖尿病肾病的患病率为16.1%;糖尿病视网膜病变的患病率为18.7%;糖尿病神经病变的患病率为37.3%。(2)收缩压和糖化血红蛋白为糖尿病视网膜病变的独立危险因素。(3)年龄、收缩压、舒张压、空腹血糖、餐后两小时血糖及糖化血红蛋白为糖尿病外周神经病变的独立危险因素。(4)初诊2型糖尿病女性糖尿病视网膜病变、糖尿病肾病的患病率高于男性。结论北京地区初诊2型糖尿病微血管病变占一定比例,微血管病变的患病率存在性别差异,控制血压、血糖有利于改善糖尿病微血管病变。     

2型糖尿病患者高尿酸血症与下肢外周动脉病关系的临床研究

目的观察2型糖尿病合并高尿酸血症患者的发病情况,探讨2型糖尿病患者高尿酸血症与下肢动脉粥样硬化的关系。方法选取住院的2型糖尿病患者420例,收集相关临床资料并检测相关生化指标。采用多普勒血流探测仪专人测定糖尿病患者的足背动脉、胫后动脉与肱动脉的比值（踝肱指数）,使用SPSS13．0统计软件进行数据分析和处理。结果2型糖尿病合并高尿酸血症的患者为126例。年龄、血压、尿酸水平与糖尿病患者合并外周动脉疾病有关联（P〈0．05）。尿酸是糖尿病患者发生外周动脉疾病的独立危险因素。结论高尿酸血症是糖尿病大血管并发症的危险因素,是2型糖尿病患者发生外周动脉疾病的强预报因子。     

住院老年2型糖尿病患者慢性并发症患病率及危险因素分析

目的分析基层医院住院的老年2型糖尿病患者慢性并发症的患病率及危险因素,为基层医院2型糖尿病慢性并发症的防治提供参考依据。方法该研究为回顾性研究,收集2015年6月—2016年12月在成都国光电气股份有限公司医院住院老年2型糖尿病患者325例病历资料。包括人体学指标、病史、个人史、生化指标等。慢性并发症按照中华医学会慢性并发症调查的实施细则计算慢性并发症的患病率。影响因素分析用多因素Logistic回归分析。结果糖尿病慢性并发症总体患病率为96.62%,其中9.54%患者合并1种慢性并发症,26.46%患者合并2种并发症,32.62%患者合并3种慢性并发症,20%患者合并4种慢性并发症,8%患者合并5种慢性并发症。冠心病患病率36.62%,脑卒中患病率18.10%,周围血管病变患病率79.69%。糖尿病肾病患病率43.35%,糖尿病视网膜病变患病率26.77%,糖尿病周围神经病变患病率86.77%。冠心病的独立危险因素:年龄、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、高血压病。脑卒中的独立危险因素:肾小球滤过率(e GFR)、甘油三酯(TG)、糖化血红蛋白(Hb A1C)。周围血管病变独立危险因素:年龄、糖尿病病程、HDL-C、TC。糖尿病肾病的独立危险因素:年龄、糖尿病病程、HDL-C。糖尿病视网膜病变的独立危险因素:尿白蛋白/肌酐(ACR)、糖尿病病程。周围神经病变独立危险因素:糖尿病病程。结论该研究人群糖尿病慢性并发症患病率96.62%,大多数患者合并2~4种慢性并发症。年龄、糖尿病病程、高血压病、Hb A1C、TC、TG、HDL-C、e GFR、ACR是糖尿病慢性并发症的独立危险因素。     

老年高血压患者肾功能不全相关危险因素分析

目的 探讨老年高血压患者肾功能不全的相关危险因素.方法 比较高血压合并慢性肾病患者(CKD组)与非CKD者(对照组)心血管病、糖尿病、高尿酸血症等患病情况和24 h动态血压参数,分析疾病和代谢异常与CKD的关系.结果 CKD组冠心病、慢性心力衰竭(CHF)、糖尿病和高尿酸血症患病例数明显多于对照组(均P＜0.05);Logistic多元回归分析显示,高尿酸血症、冠心病、CHF、糖尿病与CKD相关,是高血压患者CKD的独立危险因素.CKD组血清尿酸水平明显高于对照组;糖尿病病程显著长于对照组(均P＜0.01).患者血清尿酸水平、糖尿病病程与GFR呈显著负相关(r=-0.377,P＜0.01,r=-0.437,P＜0.05).血清尿酸水平与脉压、日间收缩压负荷正相关,与平均舒张压、夜间舒张压呈负相关;糖尿病病程与夜间收缩压呈正相关(均P＜0.05).结论 在老年高血压患者中,冠心病、CHF、高尿酸血症、糖尿病与CKD密切相关.降压治疗的同时应注意多重危险因素的管理并注意药物的选择.     

老年2型糖尿病患者高尿酸血症的相关因素分析

目的 了解老年糖尿病患者发生高尿酸血症的情况及其临床特点,并探讨老年人高尿酸血症的相关因素.方法 收集近5年在内分泌科住院60岁以上已诊断为2型糖尿病者,进行全面体格检查,统一方法测量血压,空腹静脉抽血检查血糖、尿素氮、血肌酐、血尿酸、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、糖化血红蛋白等.测定24 h尿蛋白定量.纳入资料完整的454例,根据尿酸水平不同将患者分为高尿酸组82例（18.1％）和非高尿酸组372例进行分析.结果 （1）高尿酸血症组年龄、体质指数、三酰甘油、24h尿蛋白定量等均高于非高尿酸组,糖尿病病程、肾小球滤过率低于非高尿酸组;（2）高尿酸血症与年龄（r =0.115,P＜0.001）、体质指数（r=0.159,P＜0.001）、三酰甘油（r=0.179,P＜0.001）、24 h尿蛋白定量（r=0.168,P＜0.001）呈正相关,与糖尿病病程（r=-0.136,P＜0.001）、肾小球滤过率（r=-0.274,P＜0.001）呈负相关;男性高尿酸血症者多于女性;（3）多元逐步回归分析显示：性别、体质指数、三酰甘油、24h尿蛋白定量、肾小球滤过率是高尿酸血症的独立危险因素.结论 老年2型糖尿病患者的高尿酸血症患病率18.1％.应控制体质量、降低三酰甘油、关注肾小球滤过率受损,积极防治老年2型糖尿病患者的高尿酸血症.     

您的尿酸高了吗？

有数据显示，22．5％的1型糖尿病患者和29．5％的2型糖尿病患者患有高尿酸血症（血尿酸大于7毫克／分升）。研究发现，2型糖尿病患者的血尿酸水平与慢性并发症呈正相关，尿酸是血管粥样硬化病变的独立危险因素，可加速2型糖尿病患者肾脏病变的发生与发展。冬春季节天气寒冷，人们喜欢“进补”，高嘌呤饮食容易引发尿酸升高，加重糖尿病，尤其要注意积极防治。     

老年男性高尿酸血症临床特点及相关危险因素分析

目的了解老年男性高尿酸血症患者的临床特点和各种伴随疾病与之的相关性。方法收集2002年至2004年于解放军总医院住院的老年男性高尿酸血症患者和血尿酸正常患者各225例（合并糖尿病各110例）,对血尿酸及其影响因素进行横断面回顾性分析。结果高尿酸血症病例占同期住院老年男性患者的10．5％。高尿酸血症组合并肾功能异常远高于血尿酸正常组（27．6％vs6．2％）,差异有统计学意义（P=0．0000）。高尿酸血症组年龄、体质量、体质量指数、血压、甘油三酯、总胆固醇、空腹血糖、血肌酐、血尿素、肌酐清除率及高密度脂蛋白胆固醇与血尿酸正常组比较,差异具统计学意义（P〈O．01）,冠心病、高血压、高甘油三酯血症、肾功能异常等的患病率均高于血尿酸正常组（P〈0．01）。高尿酸血症组的血尿酸与年龄、体质量、体质量指数、血压、甘油三酯、总胆固醇、糖化血红蛋白、血肌酐、血尿素、肌酐清除率显著相关（P〈0．01）。结论老年高尿酸血症患病率高,以痛风发生为临床特征者不到10％,合并肾脏功能异常者是血尿酸正常组的4．5倍,且常伴随肥胖、糖、脂代谢紊乱和高血压,也是高血压、冠心病、糖尿病、高脂血症以及其他心、脑血管疾病的危险因素。对高尿酸血症患者应加以重视,尽早检出,综合评估心血管危险因素,及时治疗。     

高尿酸血症/痛风流行病学特点及危险因素

高尿酸血症/痛风的患病率逐年攀升,呈现高流行、年轻化、男性高于女性、沿海高于内地的流行趋势.肥胖、高血压、高血脂、高血糖等与高尿酸血症/痛风的发生、发展密切相关.小剂量阿司匹林、袢利尿剂和噻嗪类利尿剂等药物亦可促进血清尿酸水平的升高.高尿酸血症是2型糖尿病、高血压、动脉粥样硬化、心血管事件、脑卒中和慢性肾脏病等疾病的独立危险因素,是痛风发作的最主要生化基础和最直接病因.对于高尿酸血症/痛风患者,应强调早期发现和早期治疗.     

Renal outcomes in patients with type 2 diabetes with or without coexisting non-diabetic renal disease

Aims

We sought not only to determine the independent predictors of non-diabetic renal disease (NDRD) but also to investigate the impact of NDRD on renal outcomes in patients with type 2 diabetes who underwent renal biopsy and were followed-up longitudinally.

Methods

The present study was conducted by reviewing the medical records of 119 type 2 diabetic patients who underwent renal biopsy at Yonsei University Health System from January 1988 to December 2008.

Results

Renal biopsy findings declared that 43 patients (36.1%) had diabetic nephropathy alone, 12 (10.1%) had NDRD superimposed on diabetic nephropathy, and 64 (53.8%) had only NDRD. On multivariate analysis, the absence of diabetic retinopathy, higher hemoglobin levels, and shorter duration of diabetes were independent predictors of NDRD in these patients. During the follow-up period, end-stage renal disease (ESRD) developed in 33 patients (27.7%). On multivariate Cox regression, higher serum creatinine levels, higher systolic blood pressure, longer duration of diabetes, and the presence of diabetic nephropathy were identified as significant independent predictors of ESRD. When the presence of diabetic retinopathy was included in the multivariate model, higher serum creatinine levels, higher systolic blood pressure, and the presence of retinopathy were shown to be independent predictors of ESRD.

Conclusions

Since diabetic patients with NDRD have significantly better renal outcomes compared to patients with biopsy-proven diabetic nephropathy, it is important to suspect, identify, and manage NDRD as early as possible, especially in type 2 diabetic patients with short duration of diabetes and those without diabetic retinopathy or anemia.     

Non-diabetic renal disease in Croatian patients with type 2 diabetes mellitus

Aim

Our study aimed to examine the prevalence of non-diabetic renal disease in selected patients with type 2 diabetes mellitus and to determine important risk factors for non-diabetic renal disease.

Methods

We conducted retrospective analysis of clinical, laboratory and pathohistological data of type 2 diabetes mellitus patients in whom renal biopsies were performed from January 2004 to February 2013 at Dubrava University Hospital Zagreb Croatia (n = 80).

Results

According to renal biopsy findings, isolated diabetic nephropathy was found in 46.25%, non-diabetic renal disease superimposed on diabetic nephropathy in 17.5% and isolated non-diabetic renal disease in 36.25% of the patients. The most common non-diabetic renal diseases found were: membranous nephropathy, followed by IgA nephropathy and focal segmental glomerulosclerosis. In univariate analysis shorter duration of diabetes, independence of insulin therapy, lower levels of HbA1c and absence of diabetic retinopathy were found to be significant clinical predictors of non-diabetic renal disease. In multivariate analysis only independence of insulin therapy (OR 4.418, 95%CI = 1.477–13.216) and absence of diabetic retinopathy (OR 5.579, 95%CI = 1.788–17.404) were independent predictors of non-diabetic renal disease.

Conclusions

This study confirmed usefulness of renal biopsy in patients with type 2 diabetes mellitus, due to the high prevalence of non-diabetic renal disease found. Since non-diabetic renal disease are potentially curable, we should consider renal biopsy in selected type 2 diabetes mellitus patients with renal involvement, especially in those with absence of diabetic retinopathy and independence of insulin therapy.     

住院老年2型糖尿病患者微血管病变的相关因素分析

目的探讨老年2型糖尿病患者微血管病变的构成比及相关因素。方法用回顾性分析的方法研究2003年～2010年于卫生部北京医院住院治疗的年龄≥60岁的2型糖尿病患者876例,分为糖尿病肾病(DN)组和非糖尿病肾病(非DN)组,糖尿病视网膜病变(DR)组和非糖尿病视网膜病变(非DR)组,糖尿病周围神经病变(DPN)组和非糖尿病周围神经病变(非DPN)组,计算DN、DR、DPN构成比,比较患者的临床特点,并探寻老年2型糖尿病患者DR、DN、DPN的相关因素。结果 (1)DN构成比为34.5%,DR构成比为42.4%,DPN构成比为82.3%。(2)DN与非DN两组间体质量指数(BMI)、糖尿病病程、高血压病程、收缩压(SBP)、舒张压(DBP)、空腹血糖(FBS)、糖化血红蛋白(HbA1c)、空腹胰岛素(Fins)、高密度脂蛋白胆固醇(HDL)、甘油三酯(TG)、尿酸(UA)均有显著性差异(P<0.05或P<0.01);DR与非DR两组间仅糖尿病病程、SBP、空腹C肽(FCP)有显著性差异(均P<0.01);DPN与非DPN两组间年龄、糖尿病病程、HbA1c、TC、LDL有显著性差异(P<0.05或P<0.01)。(3)Logistic回归结果显示,DN与SBP、HbA1c、FBS、HDL、UA、糖尿病病程有关(OR值分别为1.022、1.098、1.075、0.501、1.004,1.048,P<0.05或P<0.01);DR与SBP、HbA1c、糖尿病病程有关(OR值分别为1.017、1.102、1.097,P<0.05或P<0.01);DPN与HbA1c、LDL、糖尿病病程、年龄有关(OR值分别为1.226、1.370、1.041、1.058,P<0.05或P<0.01)。结论对于老年2型糖尿病患者,DN、DR、DPN均与糖尿病病程和HbA1c有关,控制血糖对防治微血管病变意义重大,综合控制血糖、血压、血脂、尿酸可以更好的防治糖尿病微血管并发症。     

Renal histological lesions in patients with type II diabetes mellitus

Diabetic glomerulosclerosis is the most frequent cause of renal disease in patients with type II diabetes mellitus (DM), sometimes accompanied by vascular lesions. However, other glomerular pathologies are important in these patients. The aim of this study was to evaluate the prevalence of non-diabetic nephropathy (NDN) in selected patients with type II DM, and to identify clinical markers that may predict its presence in this population. We reviewed 20 renal biopsies performed on twenty patients with type II DM. Nine of them showed diabetic nephropathy (DN) (45%), whereas eleven showed NDN (55%): 1 IgA nephropathy, 3 vasculitis and 7 membranous nephropathy. We found no differences between the two groups with regard to sex, duration of DM, insulin therapy, glycosylated haemoglobin, proteinuria, presence of nephrotic syndrome, hypertension, serum IgA level or renal size. The NDN group had haematuria in 63.6%, whereas the patients with NDN had it in 44.4% (NS). Body mass index was higher in NDN patients (30 +/- 6.7 vs 22 +/- 2.9; p < 0.01), The same was true for creatinine clearance (82.2 +/- 51.4 ml/m vs 40.4 +/- 19.6 ml/m; p < 0.05). The age at the moment of diagnosis was higher in ND patients (67 +/- 11.2 vs 54.3 +/- 4.6; p < 0.05). The 3 patients who had diabetic retinopathy were found to have DN on renal biopsy (diagnostic specificity = 100%), although 66.7% of the patients with diabetic glomerulopathy had no retinopathy. We conclude that patients with type II DM with renal findings suggesting non-diabetic renal disease frequently it have NDN, and a renal biopsy must be performed. The presence of retinopathy has a predictive value of 100% in predicting DN, therefore its existence may make this diagnostic procedure unneccesary.     

How often is NIDDM complicated with non-diabetic renal disease? An analysis of renal biopsies and the literature

Summary According to extensive autopsy studies, non-diabetic renal disease seems to be rare in diabetes mellitus, but recent publications suggest a significant prevalence of non-diabetic renal disease in non-insulin-dependent diabetic (NIDDM) patients, especially in the absence of retinopathy. The purpose of this study was to evaluate the prevalence of non-diabetic renal disease in NIDDM patients in renal biopsies from clinical practice, in patients suspected of having non-diabetic renal disease. In addition we systematically reviewed the literature. Biopsies were evaluated at the University Department of Pathology, Aarhus, Denmark, but had been collected at several departments of nephrology. In total 33 consecutive biopsies were available from 1988–1995 (mean age of patients: 62 years (range 39–75) (mean known diabetes duration 8 years (range 1–25); the main clinical reason for a biopsy was proteinuria. Renal function changes ranged from slight elevation of serum creatinine to uraemia. In addition 9 original papers, including our own material 580 patients were examined. On the basis of careful morphological evaluation according to international criteria, no patient exhibited an unequivocal sign of non-diabetic glomerular disease. Two patients had strongly but not completely convincing evidence of glomerulonephritis. One patient had some evidence of glomerulonephritis. These 3 patients also exhibited diabetic lesions. One patient with end-stage renal disease showed evidence of interstitial nephropathy without glomerular lesions. Thus, in 4 patients evidence of non-diabetic lesions was found. In the remaining 29 patients typical diffuse (n = 9) or nodular (n = 20) diabetic lesions were found. Twenty patients showed evidence of diabetic retinopathy. One of the patients with evidence of non-diabetic renal disease had simplex retinopathy. In the literature a considerable bias exists towards including patients with non-diabetic renal disease. In non-biased materials with proteinuria the prevalence of non-diabetic renal disease is very similar to our series. In microalbuminuric patients non-diabetic renal disease seems to be very rare. It can be concluded that in our material non-diabetic renal disease is uncommon in NIDDM patients, even if a clinician has suggested renal disease of other origin. A considerable bias towards including non-diabetic renal disease in NIDDM patients exists in the literature. The indication for biopsy should be evaluated carefully, and biopsy should by no means be routinely performed in NIDDM patients with proteinuria. [Diabetologia (1996) 39: 1638–1645]     

Occurrence and interrelationships of complications in insulin-dependent diabetes in Finland

The purpose of the study was to examine the prevalence and interrelationships of micro- and macrovascular complications and their risk factors in insulin-dependent (type 1) diabetic patients. The prevalence of nephropathy, retinopathy and cardiovascular disease was examined, and their associations to risk factors (glycemic control, blood pressure, blood lipid concentrations) and neuropathy were estimated in a cross-sectional study. A total of 140 type 1 diabetic patients were examined. They were grouped by gender, age, and duration of diabetes into 14 subgroups of 10 patients each. Nephropathy was observed in 40%, retinopathy in 55%, and signs of cardiovascular disease in less than 5% of patients. Microvascular complications were associated with the duration of diabetes, systolic blood pressure, and serum triglyceride concentration. The glycosylated hemoglobin (HbA_1c) level was significantly associated with the presence of nephropathy, whereas the association with retinopathy was of borderline significance. Statistically speaking, the duration of diabetes, mean systolic blood pressure, HbA_1c, and triglyceride level explained 31% of the variation in log albumin excretion rate (P<0.001). Duration, age, and triglyceride level explained 46% of the variation in the severity of retinopathy (P<0.001) and 31% of the variation in the vibration perception threshold in the ankle (P<0.001). While the well-established risk factors (duration of diabetes, hyperglycemia, and hypertension) are associated with microvascular complications, more than half of the variation in their severity cannot be explained. An additional risk factor may involve triglycerides even at a normal serum concentration. The mechanism could be the incorporation of triglycerides in the cell membrane, leading to variations in membrane fluidity. Received: 30 September 1995 / Accepted in revised form: 19 September 1996     

Prevalence of diabetic complications in fibrocalculous pancreatic diabetic patients and type 2 diabetic patients: a cross-sectional comparative study

OBJECTIVE: To determine the prevalence of diabetes-related complications in subjects with fibrocalculous pancreatic diabetes (FCPD) and compare them with subjects with type 2 diabetes mellitus matched for age, sex, and duration of diabetes. METHODS: The study group comprised of 277 FCPD patients and 277 age, sex, and duration of diabetes-matched type 2 diabetic patients. All the study subjects underwent a detailed clinical examination, and fasting blood samples were obtained for biochemical studies. Peripheral Doppler was used for diagnosis of peripheral vascular disease (PVD). Vibratory perception threshold (VPT) was determined using biothesiometry for diagnosis of neuropathy. Diagnosis of coronary artery disease (CAD) was based on medical history and 12-lead resting ECG. Retinal photographs were used for diagnosis of retinopathy using a modified version of Early Treatment Diabetic Retinopathy Study (ETDRS) grading system. RESULTS: FCPD patients had lower body mass index (BMI) (P<.001), systolic blood pressure (P<.0001), diastolic blood pressure (P<.001), serum cholesterol (P<.001), serum triglyceride (P<.001), and serum creatinine (P<.01) but higher glycosylated hemoglobin (P<.001) levels compared to patients with type 2 diabetes. Prevalence of CAD was significantly higher among type 2 diabetic patients (11.9%) compared to FCPD patients (5.1%), P<.003. There was no significant difference in the prevalence of other diabetic complications between the two study groups (type 2 diabetes vs. FCPD: retinopathy-37.2% vs. 30.1%, PVD-4.3% vs. 4.7%, Neuropathy-25.3% vs. 20.9%, Nephropathy-15.0% vs. 10.1%). Multiple logistic regression analysis revealed the following risk factors for diabetes complications among type 2 diabetic subjects-retinopathy: BMI (P=.028), duration of diabetes (P<.001), and glycosylated hemoglobin (P=.026); nephropathy: diastolic blood pressure (P=.016) and glycosylated hemoglobin (P=.040); neuropathy: age (P<.001), duration of diabetes (P=.003), and glycosylated hemoglobin (P=.001). Among subjects with FCPD, systolic blood pressure (P=.013), glycosylated hemoglobin (P=.021), and duration of diabetes (P<.001) were associated with retinopathy; BMI (P=.057), glycosylated hemoglobin (P=.010), and duration of diabetes (P=.024) with nephropathy and age (P=.011) and BMI (P=.010) with neuropathy. Conclusion: The prevalence of retinopathy, nephropathy, neuropathy, and PVD was similar among FCPD patients and type 2 diabetic patients, but the prevalence of CAD was lower among FCPD patients.     

The prevalence of retinopathy and associated medical risk factors in type I (insulin-dependent) diabetes mellitus

The prevalence of diabetic retinopathy and the associated medical risk factors, such as age at onset and duration of diabetes, metabolic control, blood pressure, albumin clearance and serum creatinine, were studied in 501 patients with type I diabetes mellitus. The prevalence of retinopathy, characterized as simplex, maculopathy, preproliferative, and proliferative, was 60.5%. Patients with retinopathy were younger at the onset of diabetes, and had a longer duration of disease. In patients with more than 10 years of diabetes, proliferative retinopathy was more frequent if onset was before they were 15 years old, despite the fact that the duration of diabetes did not differ. Patients with severe retinopathy had worse metabolic control, and were more frequently treated for hypertension. In addition, the systolic blood pressure was elevated in all groups of patients with any type of retinopathy, whereas the diastolic blood pressure was elevated only in patients with more severe forms. Patients with severe retinopathy also had higher levels of albumin clearance.     

Retinal and renal complications in patients with a mutation of mitochondrial DNA at position 3,243 (maternally inherited diabetes and deafness). A case–control study

AIMS/HYPOTHESIS: We assessed the prevalence and determinants of retinal and renal complications in patients with maternally inherited diabetes and deafness (MIDD). METHODS: This was a multicentre prospective study comparing the prevalence of retinopathy and renal disease in 74 patients with MIDD and 134 control patients matched for sex, age and clinical presentation at onset of diabetes, duration of diabetes and current treatment. Comparisons were adjusted for HbA(1c) and hypertension. RESULTS: In MIDD patients, HbA(1c) (7.6 +/- 1.6 vs 8.5 +/- 2.0%, p < 0.002), systolic blood pressure (126.6 +/- 16.2 vs 133.1 +/- 17.3 mmHg, p < 0.007) and prevalence of hypertension (33.8 vs 64.2%, p < 0.0001) were lower than in control patients. Prevalence of diabetic retinopathy was 3.7-fold lower in MIDD patients (6/74, 8 vs 40/134, 29.6%, p < 0.0001). Differences between groups remained significant after adjustment for hypertension, systolic blood pressure and HbA(1c). In MIDD, urinary albumin excretion (314.8 vs 80.1 mg/24 h, p = 0.035) and creatinine plasma levels (103.5 vs 82.2 micromol/l, p = 0.0178) were higher and GFR was lower. Impaired renal function (GFR <60 ml/min) was four- to sixfold more frequent in MIDD. Differences between MIDD and control diabetic patients further increased when adjusted for HbA(1c) and systolic blood pressure (p < 0.0001). Adjustment for treatment with an ACE inhibitor or angiotensin II receptor antagonist did not modify the results. CONCLUSIONS/INTERPRETATION: This study indicates that diabetic retinopathy is less prevalent in MIDD than in control diabetes. This suggests that retinal alterations due to mitochondrial disease may have a protective role. By contrast, nephropathy is far more frequent in MIDD, suggesting the presence of a specific renal disease independent of diabetic nephropathy.     

Association between subclinical hypothyroidism and severe diabetic retinopathy in Korean patients with type 2 diabetes

The association between subclinical hypothyroidism (SCH) and microvascular complications of type 2 diabetes is unclear. We examined whether SCH is associated with diabetic retinopathy or nephropathy in Korean patients with type 2 diabetes. Data from 489 patients who visited the diabetes clinic at a university hospital between 2001 and 2007 were analyzed retrospectively. Participants were evaluated for glycemic control, thyroid function, and diabetic retinopathy and nephropathy. Diabetic retinopathy was classified into five grades. Diabetic nephropathy was assessed by the presence of albuminuria. Patients in the SCH group had a higher proportion of women, older age, longer duration of diabetes, higher systolic and diastolic blood pressure, and higher insulin resistance index compared with the euthyroid group. No significant difference in family history of diabetes or body mass index was found between groups. The prevalence of severe diabetic retinopathy (severe nonproliferative diabetic retinopathy or proliferative diabetic retinopathy) was significantly higher in the SCH group than the euthyroid group (32.8% vs. 19.6%, P = 0.036), whereas no between-group difference was found in the prevalence of diabetic nephropathy. After adjustment for potential confounding factors (HbA1c, BMI, duration of diabetes, diabetic nephropathy, and hypertension) by multivariate logistic regression analysis, SCH remained significantly associated with severe diabetic retinopathy (odds ratio 2.086 (95% CI, 1.010-4.307), P = 0.047). These results suggest that SCH was independently associated with severe diabetic retinopathy in patients with type 2 diabetes. Further prospective studies are required to confirm the association between SCH and diabetic retinopathy.