中国基层医疗二型糖尿病人中阳痿的普遍性，相互关联，患者态度和寻求治疗的行为

本研究探讨在基层医疗二型糖尿病人中，阳痿的普遍性、相互关联、患者态度和寻求治疗的行为。我们将一份结构性匿名自填问卷发放到十所普通科门诊诊所进行横断性调查。在603位参与者（91％回应率）中，以国际勃起功能指数（iief）作定义之阳痿的普遍性为79．1％。多数参与者患轻度阳痿（28．9％），随后为轻至中度阳痿（27．9％）、中度阳痿（13．4％）及严重阳痿（9％）。接近55％的阳痿患者并不自觉患有此症。少于10％的患者曾寻求医生治疗，76．1％的参与者表示若被确诊为阳痿，会期望得到医生治理。他们认为最重要的医生治理是临床评估（41．7％），其次是治理潜在因素（37．8％）、转介专科医生（27．5％）、教育（23．9％）、处方磷酸二酯酶5型抑制剂（16．9％），及转介辅导服务（6．7％）。与诊断阳痿最密切关联的因素是自觉患有阳痿（OR=90．49（20．00—409．48，P〈0．001））、以及较年长的组别（OR=1．043（1．011-1．076，P=0．008））。总体而言，阳痿在二型糖尿病人中非常普遍。其中大部分病人如患上阳痿都希望得到医生救治，但只有少数会真正提出此要求。建议医护人员使用结构性问卷筛选二型糖尿病人中的阳痿患者，有助于找出未被诊断的阳痿个案。     

Incidence of erectile dysfunction in Italian men with diabetes

PURPOSE: We determined the incidence of erectile dysfunction in Italian men with diabetes. MATERIALS AND METHODS: We estimated the incidence of erectile dysfunction, defined as failure to achieve and maintain erection sufficient for satisfactory sexual performance, after 2.8 years of followup in 1,010 men enrolled for a prevalence study of erectile dysfunction in diabetes. RESULTS: Of the 1,010 men 192 (19%) complained of erectile dysfunction. The crude incidence rate of erectile dysfunction was 68 cases per 1,000 person-years (95% confidence interval 59 to 77). The incidence of erectile dysfunction increased with increasing age (10-fold higher for ages 70 to 79 than for 19 to 29 years), duration of diabetes (1.6-fold higher a history of 11 years or greater than for less than 5) and deteriorating metabolic control (1.7-fold higher for hemoglobin A1c greater than 9% than less than 7.5%). Moreover, it was higher in type 2 than in type 1 diabetes (74 versus 45 cases per 1,000 person-years). The relative risk was 1.75, 2.02, 1.97, 1.16, 1.86, 3.79 and 1.52 for associated obliterative arterial disease of the lower legs, ischemic heart disease, renal disease, autonomic neuropathy, sensitive and motor neuropathy, diabetic foot and retinal disease, respectively. Of the characteristics at study enrollment patient age, duration of diabetes, renal disease and hypertension were multivariate predictors of the erectile dysfunction 2.8 years later. CONCLUSIONS: The incidence of erectile dysfunction in Italian men with diabetes at a mean followup of 2.8 years was 68 cases per 1,000 person-years, more than 2-fold that in the Massachusetts Male Aging Study of the general population. The knowledge of this incidence should promote specific preventive and therapeutic interventions for erectile dysfunction in men with diabetes.     

Prevalence of undiagnosed diabetes mellitus in male erectile dysfunction.

OBJECTIVE: To determine the prevalence of previously undiagnosed diabetes mellitus (DM) in men presenting with erectile dysfunction (ED), using fasting blood glucose (FBG) compared with urinary dipstick testing for glycosuria. PATIENTS AND METHODS: A prospective prevalence study was carried out in an andrology outpatient clinic of a urology department in a district general hospital serving a mixed urban and rural population. In all, 129 consecutive men presenting with ED underwent FBG and urinary dipstick testing to detect undiagnosed DM in those presenting with ED. RESULTS: The prevalence of known DM was 17% and the that of undiagnosed DM 4.7% of the 107 remaining men; an abnormal fasting glucose level was found in a further 12%. The sensitivity of urine dipstick test for diagnosing DM was 20%. CONCLUSIONS: The prevalence of undiagnosed DM is higher in men with ED than in the general population. ED is a marker symptom for DM and DM should be actively sought in men presenting with ED. Urinary dipstick testing for glycosuria, if used as a screening test, will miss the diagnosis in 80% of these men. FBG testing should be undertaken to reliably diagnose DM in men presenting with ED.     

Clinical and psychological predictors of incidence of self-reported erectile dysfunction in patients with type 2 diabetes

PURPOSE: We evaluated the predictors of the incidence of erectile dysfunction in patients with type 2 diabetes mellitus and identified subgroups of patients in whom the interaction between clinical and psychological characteristics determined an increase in the risk of erectile dysfunction. MATERIALS AND METHODS: The study was based on 670 individuals. The presence of erectile dysfunction and the severity of depressive symptoms were investigated with a questionnaire filled in every 6 months for 3 years. Poisson regression was used to calculate incidence rates. To evaluate interactions among the different variables and identify distinct and homogeneous subgroups in terms of incidence of erectile dysfunction, RECursive Partitioning and AMalgamation method was used. RESULTS: Overall erectile dysfunction developed in 192 men with type 2 diabetes, with an incidence rate of 166.3 per 1,000 person-years. Age, insulin treatment, hemoglobin A1c greater than 8.0%, total cholesterol greater than 3.88 mmol/l and severity of depressive symptoms represented independent predictors of erectile dysfunction. RECursive Partitioning and AMalgamation analysis identified 5 classes with a marked variation in the risk of erectile dysfunction. Patients with low levels of depressive symptoms and hemoglobin A1c 8.0% or less showed the lowest risk of erectile dysfunction. Compared with this subgroup patients with higher levels of depressive symptoms and treated with insulin had a 3-fold risk of erectile dysfunction. Age, smoking, high cholesterol levels and neuropathy were globally predictive variables associated with an increased risk of erectile dysfunction. CONCLUSIONS: The incidence of erectile dysfunction is predicted by modifiable risk factors. Even in diabetes, psychological problems can contribute to the pathogenesis of erectile dysfunction, in addition to organic causes.     

ApoE isoforms, treatment of diabetes and the risk of coronary heart disease

AIM:To analyze the risk of coronary heart disease in patients with type 2 diabetes mellitus(T2DM)receiving standard medical treatment.METHODS:We performed a retrospective chart analysis of 269 middle-aged patients(age 45-64 years,mean age,53.9±5.5 years)with T2DM and without atherosclerotic cardiovascular events who underwent typing to determine their apolipoprotein E(apoE)isoforms.The apoE isoforms were determined using isoelectric focusing,followed by immunoblotting.We retrospectively evaluated the charts of the 269 patients,recorded between their first visit to the hospital(the study’s start point,between 1987 and 1992)and the occurrence of an atherosclerotic cardiovascular event(the study’s endpoint)or January 2004,whichever came first.The age-adjusted mean values and the prevalences of covariates were calculated to compare the laboratory data among the apoE phenotypes.To investigate the association of risk factors with the incidence of coronary heart disease during the follow-up period,monovariate and multivariate Cox regression models were used.RESULTS:At enrollment,the mean serum low density lipoprotein(LDL)cholesterol levels were lowest(2.92± 0.89 mmol/L)among the subjects with apoE2(apoE2/2 or apoE2/3)and highest(3.52±0.77 mmol/L)among the subjects with apoE4(apoE3/4 or apoE4/4).No significant differences in mean age or the percentage of smokers were observed among the three groups.Furthermore,no significant differences were observed in the systolic and diastolic blood pressures,body mass index,HbA1c level or serum triglyceride levels among the three groups.There were 47 cases of coronary heart disease over 3285 person-years of follow-up.An age-adjusted multivariate Cox proportional model identified diabetic retinopathy(hazard ratio,2.38,95% CI:1.28-4.43,P=0.006),a high systolic blood pressure(hazard ratio,1.04,95%CI:1.02-1.06,P<0.001) and high HbA1c values(hazard ratio,1.19,95%CI:1.02-1.38,P=0.0029),but not the LDL cholesterol value at enrollment(hazard ratio,1.01,95%CI:0.97-1.05,P=0.77)nor the specific apoE isoform,as significant predictors of coronary heart disease.CONCLUSION:Under standard medical treatment of diabetes,including the control of LDL cholesterol levels,the apoE4 isoform was not associated with coronary heart disease among T2DM patients.     

老年男性2型糖尿病患者骨密度变化的分析

目的:探讨老年男性2型糖尿病患者骨密度的变化情况.方法:应用双能X线骨密度测定法测定52例老年男性2型糖尿病患者腰椎和股骨颈的骨密度,同时检测身高,体重,血钙、磷、碱性磷酸酶,24 h尿钙,计算体质指数,并与46例同龄正常健康老年男性进行比较.结果:老年男性2型糖尿病患者骨质疏松症的患病率为11.5%,正常对照组骨质疏松的患病率为3.8%.两组间体质指数,血钙、磷及碱性磷酸酶无明显差异,但糖尿病组24 h尿钙高于正常对照组,差异具有显著性(P＜0.01).结论:老年男性2型糖尿病患者的骨质疏松患病率较正常男性明显增高,是2型糖尿病的常见并发症.     

Treatment of prediabetes

Progression of normal glucose tolerance(NGT) to overt diabetes is mediated by a transition state called impaired glucose tolerance(IGT). Beta cell dysfunction and insulin resistance are the main defects in type 2 diabetes mellitus(type 2 DM) and even normoglycemic IGT patients manifest these defects. Beta cell dysfunction and insulin resistance also contribute to the progression of IGT to type 2 DM. Improving insulin sensitivity and/or preserving functions of beta-cells can be a rational way to normalize the GT and to control transition of IGT to type 2 DM. Loosing weight, for example, improves whole body insulin sensitivity and preserves beta-cell function and its inhibitory effect on progression of IGT to type 2 DM had been proven. But interventions aiming weight loss usually not applicable in real life. Pharmacotherapy is another option to gain better insulin sensitivity and to maintain beta-cell function. In this review, two potential treatment options(lifestyle modification and pharmacologic agents) that limits the IGT-type 2 DM conversion in prediabetic subjects are discussed.     

Epidemiologie der Extremitätenfrakturen

To analyze age- and sex-specific frequencies of peripheral fractures, we used data from the third MONICA-Augsburg Survey (1994/95). The study comprises 2404 male and 2450 female participants (age 25 to 74 years) who were questioned regarding fracture history. We investigated fracture prevalence, age-specific incidence rates, and the circumstances under which the fractures occurred. The age-standardized, cumulative fracture prevalence among men (m) 25 to 74 years of age was 45% and among women (w) of the same age 31%. Fracture prevalence among women was more than 10% lower than among men in the younger age groups (age 25 to 64 years), but after an significant increase in the 65 to 74-year-olds the fracture prevalence corresponded to that of men (m: 42%, w: 40%). A peak of incidence rates was found among men at age 15-24 (overall incidence rate: 2017 fractures/100,000 person-years) and at age 45-54 (overall incidence rate: 1640 fractures/100,000 PY), respectively, and among women at age 65-74 (overall incidence rate: 3214 fractures/100,000 PY). The prevalence of self-reported osteoporosis (age 25 to 74 years) was higher in women (7%) than in men (1%). Falls caused 43% (w: 59%, m: 33%) of all fractures, external violence 40% (m: 47%, w: 29%), and sports activities 15% (m: 18%, w: 10%). Further investigation of risk factors related to fractures can contribute to the development of specific preventive measures in that field. In the future, the prevention and efficient treatment of an existing or an often undiagnosed osteoporosis and also the prevention of falls in elderly persons should be an important public health concern.     

Association between psychological distress and gastrointestinal symptoms in diabetes mellitus

AIM:To examine the possible association between gastrointestinal symptoms and anxiety and depression in type 2 diabetes mellitus(T2DM).METHODS:The study was a matched case-control study based on a face to face interview with designed diagnostic screening questionnaires for gastrointestinal(GI) symptoms and T2DM,Patient Health Questionnaire(PHQ-9) for depression and General Anxiety Disorders(GAD-7) for anxiety.The questionnaire consisted of questions about symptoms and signs of anxiety and depression disorders.Also,socio-demographic characteristics,life style habits and the family history of patients were collected.It was carried out from June 2010 to May 2011 among Qatari and other Arab nationals over 20 years of age at Primary Health Care Centers of the Supreme Council of Health,Qatar,including patients with diabetes mellitus and healthy subjects over 20 years of age.RESULTS:In the studied sample,most of the studied T2DM patients with GI symptoms(39.3%) and healthy subjects(33.3%) were in the age group 45-54 years(P < 0.001).The prevalence of severe depression(9.5% vs 4.4%,P < 0.001) and anxiety(26.3% vs 13.7%,P < 0.001) was significantly higher in T2DM patients with GI symptoms than in general population.Obesity(35.7% vs 31.2%) and being overweight(47.9% vs 42.8%) were significantly higher in T2DM patients with GI symptoms than in healthy subjects(P = 0.001).Mental health severity score was higher in T2DM patients with GI symptoms than in healthy subjects;depression(8.2 ± 3.7 vs 6.0 ± 3.6) and anxiety(7.6 ± 3.3 vs 6.0 ± 3.7).The most significant GI symptom which was considerably different from controls was early satiety [odds ratio(OR) = 10.8,P = 0.009] in depressed T2DM patients and loose/watery stools(OR = 2.79,P = 0.029) for severe anxiety.Anxiety was observed more than depression in T2DM patients with GI symptoms.CONCLUSION:Gastrointestinal symptoms were significantly associated with depression and anxiety in T2DM patients,especially anxiety disorders.     

2型糖尿病伴勃起功能障碍的相关发病因素探讨

目的:探讨中青年2型糖尿病(T2DM)患者伴发勃起功能障碍(ED)与血管、神经和雄激素等因素的关系,为ED早期防治提供临床依据。方法:53例50岁以下男性T2DM患者按国际勃起功能指数-5(IIEF-5)评分分为ED组(IIEF评分≤21,n=28)和非ED组(NED组)(IIEF评分≥22,n=28),测定两组血脂、血糖、血清总睾酮(TT)、性激素结合蛋白(SHBG)、硫酸脱氢表雄酮(DHEA-S)、计算法游离睾酮(cFT)等指标,检查两组视网膜病变(DR)、大血管病变和周围神经病变(DPN)等并发症,比较两组各指标及并发症的差异。结果:两组年龄、糖尿病病程、体重指数、血压、血脂、血糖水平具有可比性(P>0.05),ED组DR发生率(39.3%)高于NED组(4.0%)(P<0.05),两组TT、DHEA-S、cFT水平及大血管病变和DPN发生率差异均无统计学意义(P>0.05)。结论:T2DM患者伴ED发生与DR关系密切,对合并DR的T2DM患者尤应早期关注其勃起功能。     

止血相关参数对2型糖尿病和糖尿病肾病预测的临床意义

目的本研究旨在评估止血相关参数对2型糖尿病(type 2 diabetes mellitus,T2DM)和糖尿病肾病(diabetic nephropathy,DN)的预测价值。方法研究纳入96例T2DM患者分为两组,无并发症T2DM组(52例)和DN组(44例),同时纳入同期进行体检的50例性别、年龄匹配的健康人群作为对照组,测量各组基线实验室指标和止血相关参数,分析T2DM和DN的危险因素及其预测指标。结果无并发症的T2DM患者与对照组相比,活化部分促凝血酶原激酶时间(activated partial thromboplastin time,APTT)、血小板(platelets,PLT)和D-二聚体(D-Dimer,D-D)水平显著不同(P<0.01)。与没有并发症的T2DM患者相比,DN患者的纤维蛋白原(fibrinogen,FIB)、PLT和D-D增加(P<0.05)。APTT和PLT均为T2DM的独立危险因素(OR值分别为1.743、1.238,P<0.01),FIB和PLT是DN的独立危险因素(OR值分别为1.642、1.317,P<0.01)。APTT和PLT预测T2DM的ROC曲线下面积(area under curve,AUC)分别为0.601和0.642,且灵敏度较低。FIB取临界值3.15 g/L时预测DN的AUC为0.876,灵敏度(84%)和特异度(77%)较高,PLT取临界值245×109/L预测的DN的AUC为0.571,灵敏度为61%,特异度为89%。当联合FIB和PLT时,其预测DN能力增加(AUC:0.887,95%CI:0.841~0.937,灵敏度:91%,特异度:74%)。结论止血相关参数对T2DM的预测价值较低,而FIB是DN的独立危险因素,对DN有较高的预测价值。     

Prevalence of obstructive sleep apnoea in men with type 2 diabetes

BACKGROUND: A study was undertaken to establish the prevalence of obstructive sleep apnoea (OSA) in men with type 2 diabetes. METHODS: Men with type 2 diabetes from local hospital and selected primary care practitioner databases received questionnaires about snoring, apnoeas, and daytime sleepiness based on the Berlin questionnaire. Selected respondents had overnight oximetry to establish whether they had OSA. Comparisons of oximetry were made with those from a previous general population study. HbA1c results were collected. RESULTS: 1682 men were sent questionnaires, 56% of whom replied. 57% scored as "high" and 39% as "low" risk for OSA; 4% were already known to have OSA. Oximetry was performed in 240 respondents from both risk groups: 31% of the "high" and 13% of the "low" risk group had significant OSA (more than 10 >4% Sao(2) dips/hour or Sao(2) tracing consistent with OSA). These results were verified by detailed sleep studies. Extrapolation of the oximetry data to the questionnaire respondent population suggests that 23% had OSA. Comparison of the oximetry results with men from a previous general population study (using only more than 10 >4% Sao(2) dips/hour to define OSA) showed the prevalence of OSA is significantly higher in this diabetes population (17% v 6%, p<0.001). Multiple linear regression revealed BMI and diabetes as significant independent predictors of OSA. Following correction for BMI (which explained 13% of the variance in OSA), diabetes explained a further 8% of the variance (p<0.001). There was a low correlation between OSA severity and HbA1c in the subgroup recruited from the hospital database (r = 0.2, p = 0.006) which remained significant after allowing for obesity (p = 0.03). CONCLUSIONS: OSA is highly prevalent in men with type 2 diabetes; most are undiagnosed. Diabetes itself may be a significant independent contributor to the risk of OSA.     

Impact of diabetes mellitus and cardiometabolic syndrome on the risk of Alzheimer’s disease among postmenopausal women

BACKGROUNDIn spite of an increase in the incidence and prevalence of diabetes mellitus (DM) and Alzheimer’s disease (AD) in the aging population worldwide, limited attention has been paid to their potential association.AIMTo investigate the association of DM and cardiometabolic syndrome (CMS, a precursor to DM) with risk of incident AD among postmenopausal women.METHODSPostmenopausal women aged 50-79 (n = 63117) who participated in the U.S. Women’s Health Initiative Observational Study (WHIOS), recruited in 1993-1998, without baseline AD and followed up through March 1, 2019, were analyzed. AD was classified by participant-reported history of doctor-diagnosis of incident AD in the WHIOS. DM was defined by participant-report or treated because of diabetes or serum glucose concentrations ≥ 126 mg/dL. CMS was defined as having ≥ 3 of five CMS components: large waist circumference, high blood pressure, elevated triglycerides, elevated glucose, and low high-density lipoprotein cholesterol. The associations of DM and CMS with AD were analyzed using Cox’s proportional hazards regression analysis.RESULTSDuring a median follow-up of 20 years (range: 3.36 to 23.36 years), of 63117 participants, 8340 developed incident AD. Women with DM had significantly higher incidence of AD [8.5, 95% confidence interval (CI): 8.0-9.0 per 1000 person-years (PY)] than those without DM (7.1, 95%CI: 6.9-7.2 per 1000 PY). Multivariate Cox’s regression analysis indicated that women with DM or CMS had a significantly higher risk of AD than those without DM or CMS. The corresponding hazard ratios [HR (95%CI)] were 1.22 (1.13-1.31, P < 0.001) in subjects with DM, and 1.18 (1.09-1.27, P < 0.001) in subjects with CMS. The HRs diminished with age and became non-significant in the oldest age group.CONCLUSIONDuring a median follow-up of 20 years, DM and CMS were significantly associated with the risk of AD among postmenopausal women. More specifically, women aged 50-69 with DM or CMS vs those without these conditions had significantly higher relative risks of AD than the relative risks of AD in those aged 70-79 with DM or CMS vs those without DM or CMS.     

Incidence,surgical procedures,and outcomes of hip fracture among elderly type 2 diabetic and non-diabetic patients in Spain (2004–2013)

Summary

Hip fracture is a serious public health problem. We used Spanish hospital discharge data to examine trends in 2004–2013 in the incidence of hip fracture among elderly patients. We found that hip fracture incidence is higher in subjects with than without diabetes and is much higher among women than men.

Introduction

This study aimed to describe trends in the incidence of hip fracture hospitalizations, use of surgical procedures, and hospital outcomes among elderly patients with and without type 2 diabetes mellitus (T2DM) in Spain, 2004–2013.

Methods

We selected all patients with a discharge primary diagnosis of hip fracture using the Spanish national hospital discharge database. Discharges were grouped by diabetes status: Incidences were calculated overall and stratified by diabetes status and year. We analyzed surgical procedures, length of hospital stay (LOHS), and in-hospital mortality (IHM). Multivariate analysis was adjusted by age, year, comorbidity, and in-hospital complications (IHC).

Results

From 2004 to 2013, 432,760 discharges with hip fracture were identified (21.3 % suffered T2DM). Incidence among diabetic men and women increased until year 2010 and then remained stable. Diabetic women have three times higher incidence than diabetic men. Incidences and IHC were higher among patients with diabetes beside sex. The proportion of patients that underwent internal fixation increased for all groups of patients and the arthroplasty repair decreased. After multivariate analysis, IHM has improved over the study period for all patients. Suffering diabetes was associated to higher IHM in women (odds ratio (OR) 1.12; 95 % confidence interval (CI) 1.07–1.17).

Conclusions

Hip fracture incidence is higher in subjects with than without diabetes and is much higher among women than men. In diabetic patients, incidence rates increased initially but have leveled from 2010 onwards. For all groups, the use of internal fixation has increased overtime and IHM and LOHS have decreased from 2004 to 2013.

     

不同骨密度检测方法在2型糖尿病骨质疏松患者中的应用

目的 探讨2型糖尿病患者骨质疏松的相关指标,为早期诊断和治疗提供理论依据.方法 选取2011年3月～11月在某院已确诊为2型糖尿病的住院患者60例为病例组,同期健康体检者52例为正常对照组,分别采用跟骨超声骨密度检测仪(QUS)、双能X线(DEXA)、周围骨定量CT(pQCT)进行骨密度检测.结果 用QUS、DEXA及pQCT测定60例2型糖尿病患者提示骨质疏松者分别占45 %、51.7%、46.8%.而与对照组比较,2型糖尿病患者骨密度显著低于正常对照组(P＜0.05),2型糖尿病患者骨质疏松相关指标异常者占51.7%;在2型糖尿病患者中,女性2型糖尿病患者骨质疏松相关指标显著低于男性(P＜0.05).结论 2型糖尿病患者容易并发骨质疏松,其中女性2型糖尿病患者的患病率更高.     

The prevalence and predictors of erectile dysfunction in men with newly diagnosed with type 2 diabetes mellitus

OBJECTIVE: To determine the prevalence of and risk factors for erectile dysfunction (ED) in men newly diagnosed with type 2 diabetes mellitus (DM). PATIENTS AND METHODS: All consecutive samples of men newly diagnosed with type 2 DM attending the diabetes centre in the capital of Kuwait were included in the study. Face-to-face interviews with the men were conducted using the International Index of Erectile Function (IIEF)-5 questionnaire. A threshold IIEF-5 score of <21 was used to identify men with ED. Pertinent clinical and laboratory characteristics were collected. RESULTS: Of 323 men with newly diagnosed type 2 DM, 31% had ED; comparing potent men and men with ED, there were statistically significant differences for smoking, duration of smoking, hypertension, education level, body mass index and serum glycosylated haemoglobin level. Among these, age was the most important risk factor identified by multivariate logistic regression. CONCLUSION: About a third of men with newly diagnosed type 2 DM had ED; this was associated with many variables, but most notably with age at presentation.     

Annual incidence of persistent proteinuria in the general population from Ibaraki annual urinalysis study

Background

For a definitive diagnosis of chronic kidney disease, at least 2 consecutive positive results of proteinuria with an interval of >3 months are required. However, most previous reports were based on single-screening data.

Patients and methods

The subjects in this study were participants in an annual health examination held in Ibaraki, Japan, between 1993 and 2003. The follow-up duration with serial urinalysis for 3 years of patients who were negative for proteinuria in the initial year was 330,614 person-years in males and 687,381 person-years in females among 81,854 male and 155,256 female subjects. We evaluated the incidence and risk factor for the incidence of proteinuria and persistent proteinuria.

Result

The annual incidence of proteinuria and persistent proteinuria was 1.31 and 0.33 % in males and 0.68 and 0.14 % in females. Among the subjects without hypertension and diabetes, the annual incidence was 0.81 and 0.16 % in males and 0.37 and 0.06 % in females, respectively. Risk analysis indicated that hypertension in males [hazard ratio (HR) 2.052] and females (2.477), diabetes in males (3.532) and females (3.534) and reduced renal function in males (3.097) and females (2.827) were significant positive risks for development of persistent proteinuria.

Conclusion

By annual urinalysis screening of the general population, 1 out of 303 male subjects and 1 out of 725 female subjects developed persistent proteinuria every year. Subjects with diabetes, hypertension and reduced renal function had a 2 or 3 times higher risk for the incidence of persistent proteinuria in both males and females.     

FRAX工具预测桂西地区2型糖尿病患者骨折风险的相关性分析

目的应用FRAX工具预测桂西地区2型糖尿病患者骨质疏松性骨折风险,评估FRAX工具针对该地区的应用价值及人群适用性。方法选取2015年1月至2015年4月来右江民族医学院附属医院就诊并住院治疗的部分桂西地区2型糖尿病(T2DM)患者198例,后根据纳入标准筛选出67例,并收集骨折风险要素的有关临床资料及骨密度测量T值。依据超声骨密度T值将被选者分为3组,T≥-1为正常组:37例;-2.5相似文献   

Vertebral Fracture Risk in Diabetic Elderly Men: The MrOS Study

Type 2 diabetes (T2DM) is associated with a significant increase in risk of nonvertebral fractures, but information on risk of vertebral fractures (VFs) in subjects with T2DM, particularly among men, is lacking. Furthermore, it is not known whether spine bone mineral density (BMD) can predict the risk of VF in T2DM. We sought to examine the effect of diabetes status on prevalent and incident vertebral fracture, and to estimate the effect of lumbar spine BMD (areal and volumetric) as a risk factor for prevalent and incident morphometric vertebral fracture in T2DM (n = 875) and nondiabetic men (n = 4679). We used data from the Osteoporotic Fractures in Men (MrOS) Study, which enrolled men aged ≥65 years. Lumbar spine areal BMD (aBMD) was measured with dual‐energy X‐ray absorptiometry (DXA), and volumetric BMD (vBMD) by quantitative computed tomography (QCT). Prevalence (7.0% versus 7.7%) and incidence (4.4% versus 4.5%) of VFs were not higher in T2DM versus nondiabetic men. The risk of prevalent (OR, 1.05; 95% CI, 0.78 to 1.40) or incident vertebral‐fracture (OR, 1.28; 95% CI, 0.81 to 2.00) was not higher in T2DM versus nondiabetic men in models adjusted for age, clinic site, race, BMI, and aBMD. Higher spine aBMD was associated with lower risk of prevalent VF in T2DM (OR, 0.55; 95% CI, 0.48 to 0.63) and nondiabetic men (OR, 0.66; 95% CI, 0.5 to 0.88) (p for interaction = 0.24) and of incident VF in T2DM (OR, 0.50; 95% CI, 0.41 to 0.60) and nondiabetic men (OR, 0.54; 95% CI, 0.33 to 0.88) (p for interaction = 0.77). Results were similar for vBMD. In conclusion, T2DM was not associated with higher prevalent or incident VF in older men, even after adjustment for BMI and BMD. Higher spine aBMD and vBMD are associated with lower prevalence and incidence of VF in T2DM as well as nondiabetic men. © 2017 American Society for Bone and Mineral Research.     

Glycosylated haemoglobin levels and the severity of erectile function in diabetic men

OBJECTIVE: To evaluate the association between the levels of glycosylated haemoglobin (HbA1c) and the severity of erectile dysfunction (ED) in men with diabetes mellitus (DM). PATIENTS AND METHODS: This cross-sectional study included sexually active men with a diagnosis of DM attending a urological medical centre from January 2000 to December 2001. The 115 men with ED (95%) completed the International Index of Erectile Function questionnaire, and fasting serum glucose and HbA1c serum levels were measured. The relationship between the severity of ED and serum HbA1c levels was assessed. RESULTS: Of men with HbA1c levels of < 8%, half had mild, and 18% and 32% had moderate and severe ED, respectively (P = 0.038); of men with HbA1c levels of > or = 8%, 25%, 29%, and 46% had mild, moderate and severe ED, respectively (P = 0.008). In addition, men with HbA1c levels of > or = 11% had a statistically higher prevalence of severe ED (P = 0.002). There was no difference in severity of ED in the HbA1c subgroups when the duration of DM was < or = 5 years (P = 0.87), but most men with HbA1c levels of > or = 8% and a history of DM of 6-10 or > 10 years had severe ED (P < 0.03). CONCLUSION: This study suggests that the severity of ED is associated with increasing HbA1c levels in diabetic men.