500例住院糖尿病患者慢性并发症分析

我们进行了1991～2000年在我院住院患者糖尿病慢性并发症十年回顾性分析。     

糖尿病慢性并发症患病率及相关危险因素分析

糖尿病慢性并发症是糖尿病患者致残、致死的重要原因，其发病与许多危险因素有密切关系。我们调查了海口地区1999～2000年部分住院糖尿病患者504例，对其慢性并发症患病率及其危险因素作了相关分析。现报告如下。     

老年2型糖尿病患者血管并发症的危险因素分析

糖尿病血管并发症已成为糖尿病(DM)患者致死、致残的主要因素。我们对广西地区551例老年T2DM患者进行调查，并分析了老年T2DM患者血管并发症的发病特点，探讨其危险因素。     

中山市住院2型糖尿病患者慢性并发症发病情况调查及危险因素分析

目的 调查中山市住院2型糖尿病(T2DM)患者慢性并发症发病情况,并分析其相关危险因素。方法2019年6月—2021年5月选取该院及医联体单位143例T2DM患者,通过自制调查问卷收集患者人口学特征、饮食、饮酒、吸烟、并发症发生情况、受教育程度、家族史、糖化血红蛋白(HbA1c)、空腹血糖(FBG)等基础资料。Logistic回归分析T2DM患者慢性并发症的相关危险因素。结果 该组143例T2DM患者慢性并发症发生率为27.27%(39/143);并发症组年龄、BMI、病程、吸烟、HbA1c水平、血脂异常、高血压、FBG水平与非并发症组对比,差异有统计学意义(P<0.05);Logistic回归分析,年龄≥60岁、BMI≥24 kg/m²、吸烟、病程>10年、HbA1c水平>9%、血脂异常、高血压是T2DM患者出现慢性并发症的独立危险因素(P<0.05)。结论 中山市住院T2DM患者慢性并发症发生风险较高,年龄、BMI、吸烟、病程、血脂异常、高血压、HbA1c水平是其重要影响因素,据此完善临床干预体系,利于减少并发症发生。     

2型糖尿病患者慢性并发症的患病率及相关因素分析

<正>糖尿病是一组呈全球流行趋势的慢性代谢性疾病。随着经济的发展和人民生活方式的改变以及人口老龄化,糖尿病患病率逐年增加是全球范围内的共同趋势。美国国家糖尿病委员会报道糖尿病病人患     

胰岛素强化治疗糖尿病住院患者低血糖发生率及其危险因素分析

目的探讨胰岛素强化治疗糖尿病住院患者低血糖发生率及其相关危险因素。方法将糖尿病患者354例分为持续皮下胰岛素注射(CSII)组220例和多次皮下胰岛素注射(MSII)组134例。收集病史,检测临床指标,统计低血糖发生率,分析低血糖相关因素。结果低血糖发生率51.13%。低血糖组与无低血糖组年龄[(54.4±14.3)vs(51.2±14.4)岁,P0.05]、BMI[(23.3±3.6)vs(25.4±3.6)kg/m2,P0.01]、住院时间[(14.1±9.1)vs(10.8±6.4)d,P0.01]、血肌酐(Scr)[(104.9±118.6)vs(72.8±48.9)μmol/L,P0.01]、血糖达标时间[(11.8±7.3)vs(9.2±5.9)d,P0.01]、糖尿病并发症(冠心病、糖尿病慢性肾脏疾病)和代谢异常因素(脂肪肝、脂代谢异常)比较差异有统计学意义。Logistic多元逐步回归分析显示,BMI、Scr、脂肪肝和脂代谢异常进入方程。结论胰岛素强化治疗糖尿病住院患者低血糖发生率高。低BMI、高Scr为其独立危险因素,脂肪肝、脂代谢异常为其保护性因素。     

2型糖尿病者微血管并发症相关危险因素分析

目的探讨2型糖尿病微血管并发症的相关危险因素,为干预治疗提供依据。方法2型糖尿病患者342例,分为合并微血管并发症组158例和无微血管病并发症组184例,比较两组临床及生化指标的差异。结果2型糖尿病合并微血管病并发症组与无微血管病并发症组比较,病程、空腹血糖、肌酐、尿酸、甘油三酯有统计学差异（P〈0．05或〈0．01）;Logistic回归分析显示,糖尿病微血管并发症的发生与病程、血压、血糖、尿酸、甘油三酯密切相关（r分别为2．840、1．975、1．785、2．983、1．513,P均〈0．05）。结论长病程、高血糖、高血压、高甘油三酯、高尿酸是2型糖尿病患者发生微血管并发症的独立危险因素。     

门诊2型糖尿病患者慢性并发症患病率调查及危险因素分析

对我院门诊439例糖尿病患者进行详细问诊、全面体格检查、周围神经病变检查、踝肱指数测定、糖尿病足检查、眼底检查及血糖、血脂、糖化血红蛋白、尿微量白蛋白（白蛋白/肌酐比）等检查。发现2型糖尿病患者中视网膜病变的患病率为24.6%,糖尿病肾病19.2%,周围神经病变63.6%,冠心病18.2%,脑血管病变9.1%,下肢大血管病变9.4%。患者的年龄、病程及血糖、血压、血脂控制水平等因素与慢性并发症的发生密切相关。     

老年2型糖尿病慢性微血管并发症发病时间及危险因素临床分析

目的 分析老年2型糖尿病慢性微血管并发症发病时间,探讨影响慢性微血管并发症发生的危险因素。方法 选取该院2019年8月—2021年7月收治的191例老年2型糖尿病患者为研究对象,调查了解患者的慢性微血管并发症发生情况,记录其发病时间,对比发生慢性微血管并发症患者与未发生慢性微血管并发症患者在性别比例、年龄、2型糖尿病病程、体质指数（BMI）、血压指标水平、血糖指标水平、血脂指标水平等方面的差异性,对于影响慢性微血管并发症发生的危险因素进行判断。结果 在不同病程的老年2型糖尿病患者中,发生慢性微血管并发症60例（31.41%）,病程达到1年、2年、3年、4年、5年及以上患者的并发症发生率分别为10.34%、13.95%、22.86%、38.46%、57.78%。病程的增加,会导致慢性微血管并发症发生率的提升。与未发生慢性微血管并发症的患者相比,发生慢性微血管并发症患者的年龄、病程、BMI水平、收缩压（SBP）水平、舒张压（DBP）水平、总胆固醇（TC）水平、低密度脂蛋白胆固醇（LDL-C）水平、三酰甘油（TG）水平、糖化血红蛋白（HbA1c）水平、空腹血糖（FPG）水平相对更高,差异有统...     

内科老年糖尿病住院患者慢性并发症分析及护理对策探讨

目的:讨论内科老年糖尿病住院患者慢性并发症分析及护理对策.方法:选择200例老年糖尿病住院患者,分为两组,使用综合护理干预的为实验组,使用常规护理干预的为对照组.结果:两组的治疗效果,生活质量评分,治疗依从性以及护理满意度,并发症发生率,血糖水平相比,差异较大(P<0.05).结论:在内科老年糖尿病住院患者中使用综合护...     

The association between taking a course or class in self-managing diabetes with diabetic ocular complications including diabetic retinopathy: A cross-sectional study

AimsDiabetes currently affects 30.3 million people in the United States. The objective of this study was to investigate the association between taking a course in self-managing diabetes and diabetic ocular complications including diabetic retinopathy diagnosis (OC-RD).MethodsThe sample was from the 2017 CDC’s BRFSS participants. We included adults who self-reported they had diabetes. The exposure included those who took a course in how to self-manage diabetes. The outcome was those told they had OC-RD by a doctor. Unadjusted and adjusted logistic regression analysis were used to calculate the odds ratios (OR) and 95% confidence intervals (CI).ResultsThe odds of OC-RD decreased by 30% for those who did not attend a course compared to those who did (OR 0.70; 95% CI 0.60?0.80). Patients who saw a doctor showed a 50% increase in the odds of OC-RD than those who did not (OR 1.50; 95% CI 1.20–1.90). Those earning above $15,000 had a 10% decreased likelihood of OC-RD every time income level increased.ConclusionsTaking a class on self-managing diabetes was associated with an increased risk of OC-RD in the diabetic population. Future studies may analyze how education will affect diabetic complications.     

Genetics of cardiovascular and renal complications in diabetes

The development of debilitating complications represents a major heathcare burden associated with the treatment of diabetes. Despite advances in new therapies for controlling hyperglycemia, the burden associated with diabetic complications remains high, especially in relation to cardiovascular and renal complications. Furthermore, an increasing proportion of patients develop type 2 diabetes at a younger age, putting them at higher risk of developing complications as a result of the increased exposure to hyperglycemia. Diabetes has become the main contributing cause to end‐stage renal disease in most countries. Although there has been important breakthroughs in our understanding of the genetics of type 1 and type 2 diabetes, bringing important insights towards the pathogenesis of diabetes, there has been comparatively less progress in our understanding of the genetic basis of diabetic complications. Genome‐wide association studies are beginning to expand our understanding of the genetic architecture relating to diabetic complications. Improved understanding of the genetic basis of diabetic cardiorenal complications might provide an opportunity for improved risk prediction, as well as the development of new therapies.     

体重指数与初诊2型糖尿病代谢状态及慢性并发症的关系

目的探讨肥胖程度与糖尿病患者代谢状态及慢性并发症的关系。方法将新诊断的2型糖尿病患者以体重指数分为3组，分别比较空腹血糖及餐后血糖、血压、血脂、胰岛素抵抗指数、空腹C肽水平及大血管／微血管并发症患病率。结果低体重患者主要临床特征为胰岛素分泌水平低下，HbA1C。及空腹血糖增高。超重、肥胖的糖尿病患者主要表现为高血压、胰岛素抵抗、高甘油三酯和低高密度脂蛋白胆固醇血症。超重组易伴发高血压及冠心病等大血管病变，而低体重组微血管病变尤其是视网膜病变较为突出。结论对于初诊的低体重患者，应尽早补充胰岛素并及时筛查视网膜病变等微血管并发症：对于超重患者应强调减肥、降压、调脂等综合治疗。     

2型糖尿病患者腹部脂肪分布与糖尿病并发症的相关性研究

目的探讨2型糖尿病患者腹部脂肪分布与糖脂代谢及糖尿病并发症的关系。方法选本院内分泌科住院的2型糖尿病患者357例,定量CT测量内脏脂肪(VAT)和皮下脂肪(SAT)面积,同时检查患者糖尿病肾病、视网膜病变、周围神经病变、外周动脉粥样硬化、心脑血管疾病的患病情况。根据VAT的值以三分位数法分为3组:T1组(VAT<162.0 cm^2)、T2组(162.0≤VAT<221.1 cm^2)、T3组(VAT≥221.1 cm^2)。结果T1组HbA1C水平高于T3组(P<0.05);T1组高密度脂蛋白胆固醇(HDL-C)、肾小球滤过率(eGFR)高于T2、T3组(P<0.05);T2、T3组男性比例、年龄、体重指数(BMI)、收缩压、舒张压、三酰甘油(TG)、24h尿白蛋白、糖尿病肾病和外周动脉粥样硬化的比例高于T1组(P<0.05);T3组空腹C肽(FCP)、改良稳态模型评估的胰岛素抵抗指数(HOMA-IR)高于T1、T2组(P<0.01)。Spearman相关分析显示,VAT、SAT与BMI、FCP、HOMA-IR呈正相关(P<0.01),VAT与年龄、收缩压、舒张压、TG、24h尿白蛋白、糖尿病肾病、外周动脉粥样硬化、心脑血管疾病呈正相关(P<0.05),与HbA1C、HDL-C、eGFR呈负相关(P<0.05),SAT与总胆固醇、低密度脂蛋白胆固醇呈正相关(P<0.01),与外周动脉粥样硬化呈负相关(P<0.01)。多因素相关分析显示,校正年龄、BMI、收缩压、空腹血糖等因素后,VAT仍是发生糖尿病肾病的危险因素(P=0.013)。结论VAT、SAT均与血脂和胰岛素抵抗相关,VAT可能是2型糖尿病患者发生糖尿病肾病的危险因素。     

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。     

老年糖尿病患者自由基与微血管并发症关系的探讨

目的　探讨老年糖尿病患者自由基和抗氧化能力的变化及其与微血管并发症的关系。　方法　测定 6 5例老年糖尿病患者和 6 5例健康老年对照者血浆或红细胞中脂质过氧化物 (LPO)、超氧化物岐化酶 (SOD)、过氧化氢酶 (CAT)、谷胱甘肽过氧化物酶 (GSH PX)、维生素C(VC)、维生素E(VE)、β 胡萝卜素 (β CAR)、谷胱甘肽 (GSH) ,同时测定患者的空腹血糖、餐后 2h血糖、糖化血红蛋白(HbA1c)、空腹和餐后 2hC肽、血脂、尿微量白蛋白排泄率、肌电图。　结果　老年糖尿病患者LPO(42 97± 6 99)nmol/g高于健康老年组 (31 5 9± 7 4 4 )nmol/g ,SOD(1712 4 4± 15 7 0 4 )U/L、CAT(2 17 0 1± 2 9 36 ) μg/g、GSH PX(2 1 0 1± 3 38)× 10 -10 U/RBC、VC(40 98± 10 5 1) μmol/L、VE(16 4 4± 2 4 5 ) μmol/L、β CAR(1 19± 0 2 3) μmol/L、GSH(0 98± 0 16 )nmol/L低于健康老年组〔分别为 (192 8 38± 14 3 4 4 )U/L、(2 6 4 4 0± 6 3 5 5 ) μg/g、(2 5 16± 6 4 1)× 10 -10 U/RBC、(5 2 2 3± 10 5 1) μmol/L、(2 3 0 4± 5 38) μmol/L、(1 6 3± 0 4 0 ) μmol/L、(1 2 5± 0 2 0 )nmol/L〕 ,合并糖尿病微血管并发症者变化更加明显 ,LPO和年龄呈正相关 (r=0 310 ,P <0 0 5 ) ,SOD、C     

Associations between urinary 6-sulfatoxymelatonin excretion and diabetic vascular complications or arteriosclerosis in patients with type 2 diabetes

Aims/IntroductionThere are limited reports on the association between melatonin levels and vascular complications in patients with type 2 diabetes. The aim of this study was to determine the association between urinary 6‐sulfatoxymelatonin, which is a urinary metabolite of melatonin, and diabetic vascular complications or arteriosclerosis in patients with type 2 diabetes.Materials and MethodsThis retrospective study included patients (167 patients with type 2 diabetes and 27 patients without diabetes adjusted for age and sex) admitted to the hospital who underwent measurement of urinary 6‐sulfatoxymelatonin. The urinary 6‐sulfatoxymelatonin/creatinine ratio (6‐SMT) was calculated.ResultsThe natural logarithmically scaled 6‐SMT level (Ln 6‐SMT) was significantly lower in type 2 diabetes patients (1.9 ± 1.1) compared with patients without diabetes (2.8 ± 1.0, P < 0.001). Multivariate linear regression analysis identified duration of diabetes, smoking status, urinary albumin‐to‐creatinine ratio, retinopathy and coronary heart disease as factors that could influence Ln 6‐SMT levels in type 2 diabetes patients (R ² = 0.232, P < 0.001). Ln 6‐SMT was associated with decreased odds of diabetic retinopathy, even after adjustment for various confounding factors (odds ratio 0.559, 95% confidence interval 0.369–0.846, P = 0.006). Similarly, Ln 6‐SMT was associated with decreased odds of coronary heart disease (odds ratio 0.442, P = 0.030).ConclusionsOur results showed the presence of low levels of Ln 6‐SMT in type 2 diabetes patients relative to patients without diabetes. Furthermore, Ln 6‐SMT is an independent risk factor of diabetic retinopathy and coronary heart diseases. These findings suggest that 6‐SMT could be a useful biomarker for the prediction of micro‐ and macrovasculopathies in patients with type 2 diabetes.     

LDL-apheresis contributes to survival extension and renal function maintenance of severe diabetic nephropathy patients: A retrospective analysis

AimsLow-density lipoprotein (LDL)-apheresis removes various molecules including LDL/oxidized LDL and inflammatory cytokines and recovers clinical laboratory parameters. It is not yet known whether these advantages of LDL-apheresis improve the prognosis of patients with diabetic nephropathy accompanied by nephrotic syndrome.MethodsIn this study, three groups of patients were retrospectively surveyed in a single center, and followed for approximately 3 years: an LDL-apheresis cohort (LDL-a; N = 20); a control cohort meeting the selection criterion of severe proteinuria ≥3 g/24 h (control-All; N = 55); and a subgroup of control-All with more severe proteinuria ≥5 g/24 h (control-mSP; N = 10), and evaluated the outcomes as survival and renal dysfunction and death/renal dysfunction free rate.ResultsDeath/renal dysfunction free rate was significantly higher in LDL-a than control-All (χ² = 4.50; P = 0.03) and control-mSP (χ² = 27.68; P < 0.001).ConclusionThese results suggest the possibilities which LDL-apheresis is considered to contribute to survival extension and renal function maintenance of severe diabetic nephropathy patients.     

Association of C-peptide with diabetic vascular complications in type 2 diabetes

AimFasting serum C-peptide is a biomarker of insulin production and insulin resistance, but its association with vascular complications in type 2 diabetes mellitus (T2DM) has never been fully elucidated. This study aimed to investigate whether C-peptide is associated with cardiovascular disease (CVD) and diabetic retinopathy (DR).MethodsA total of 4793 diabetes patients were enrolled from seven communities in Shanghai, China, in 2018. CVD was defined as a self-reported combination of previous diagnoses, including coronary heart disease, myocardial infarction and stroke. DR was examined using fundus photographs. Logistic regression analyses were performed, and multiple imputed data were used to obtain stabilized estimates.ResultsPrevalence of CVD increased with increasing C-peptide levels (Q1, Q2, Q3 and Q4: 33%, 34%, 37% and 44%, respectively; P_{for trend} < 0.001), whereas DR prevalence decreased with increasing C-peptide quartiles (Q1, Q2, Q3 and Q4: 21%, 19%, 15% and 12%, respectively; P_{for trend} < 0.001). On logistic regression analysis, C-peptide levels were significantly associated with CVD prevalence (1.27, 95% CI: 1.13–1.42; P < 0.001) and C-peptide quartiles (Q1: reference; Q2: 1.31, 95% CI: 1.00–1.70; Q3: 1.53, 95% CI: 1.16–2.01; Q4: 1.76, 95% CI: 1.32–2.34; P_{for trend} < 0.001). Given the interaction between C-peptide and BMI and the association between C-peptide and CVD (P_{for interaction} = 0.015), study participants were divided into two subgroups based on BMI which revealed that the association persisted despite different BMI statuses. However, DR prevalence decreased with increasing C-peptide levels (0.73, 95% CI: 0.62–0.86; P < 0.001) and quartiles (Q1: reference; Q2: 1.00, 95% CI: 0.76–1.33; Q3: 0.69, 95% CI: 0.50–0.94; Q4: 0.51, 95% CI: 0.36–0.72; P_{for trend} < 0.001).ConclusionC-peptide was positively associated with CVD, but inversely associated with DR progression. The association between C-peptide and CVD could be due to associated metabolic risk factors.