2型糖尿病合并外周血管病变相关危险因素探讨

目的探讨2型糖尿病（T2DM）患者发生外周血管病变（PVD）的危险因素。方法选取180例T2型DM患者,其中合并PVD80例,无PVD100例,检测相关临床指标。结果T2DM合并PVD组糖尿病病程、血清肌酐、总胆固醇、高密度脂蛋白胆固醇、高血压、脑梗死史、高敏C反应蛋白（hsC-RP）和白细胞介素6（IL-6）水平显著高于无PVD组。多因素回归分析显示hsC-RP和糖尿病病程与T2DM并发PVD正相关。结论hsC-RP是促使T2DM并发PVD的独立危险因素。     

Endothelial dysfunction in type 2 diabetes mellitus subjects with peripheral artery disease

We strived to characterize the endothelial function status in type 2 diabetic patients with peripheral artery disease which was detected by ankle-brachial index by utilizing high frequency ultrasounds. Predictors of endothelial dysfunction were investigated. We chose 23 type 2 diabetic patients had ankle-brachial index <0.97 (0.15-0.95; mean=0.74+/-0.20), 31 diabetic patients had ankle-brachial index >/=1.0 and 28 non-diabetic subjects for study. Older age, a longer duration of diabetes, higher systolic blood pressure, higher prevalence of history of hypertension were observed in patients with peripheral vascular disease. Type 2 diabetic patients showed impaired flow-mediated dilatation than non-diabetic and it showed more impaired in patients with peripheral vascular disease. Nitroglyerin-induced dilatation showed a trend of impairment in patients with peripheral vascular disease but did not reach statistical significance. Age (r=-0.259, P=0.019), baseline brachial artery diameter (r=-0.321, P=0.003), ankle-brachial index (r=0.259, P=0.002) and hypertension history (P=0.01) were significantly associated with flow-mediated dilatation. However, after adjusting for age, only baseline diameter and ankle-brachial index were independent predictors of flow-mediated dilatation. In conclusion, we demonstrated flow-mediated dilatation was impaired in type 2 diabetic patients and it was further impaired in patients with peripheral vascular disease. Nitroglycerin-induced dilatation showed a trend of impairment but did not reach statistical significance.     

Sex- and BMI-related differences in risk factors for coronary artery disease in patients with type 2 diabetes mellitus

There are contrasting data about the relationship between obesity and macrovascular complications in type 2 diabetes mellitus, and it is not known if risk factors for coronary artery disease are different in normal weight and overweight or obese patients. All 2113 patients with type 2 diabetes mellitus referring to the Diabetic Clinic of Asti were studied. Patients were divided into tertiles of body mass index, according to their sex (BMI < 26.9; ≥ 26.9 and < 31.4; ≥ 31.4 kg/m² for females and BMI < 25.7; ≥ 25.7 and < 28.8; ≥ 28.8 kg/m² for males). Age, BMI, duration of diabetes, blood pressure, HbA_1c total cholesterol, HDL-cholesterol, LDL-cholesterol, and prevalence of insulin treatment and hypertension were higher in females, whereas exercise, alcohol intake, smoking habits and prevalence of dyslipidemia were higher in males. An increase in BMI was associated with an increase in HbA_1c, number of cigarettes/day, blood pressure, triglycerides, C-peptide, prevalence of hypertension and dyslipidemia, and with a decrease in age, duration of diabetes and HDL-cholesterol values. In spite of an apparently worse cardiovascular risk profile, females showed a 50% lower prevalence of CAD than males and the prevalence of CAD was not significantly different in obese compared to other BMI categories. Multiple logistic regression showed that risk factors for CAD were different in males and females and similar in the lower tertiles of BMI, while different in the highest. In obese females, risk factors for CAD were age, reduced HDL-cholesterol and increased HbA_1c levels; in males they were years of smoking and duration of diabetes. These data suggest that in type 2 diabetes, risk factors for CAD are different in the two sexes and in patients with the highest BMI compared to the normal and overweight subjects; blood glucose control and duration of diabetes seem more important than conventional cardiovascular risk factors in obese patients. Received: 11 May 1998 / Accepted in revised form: 30 July 1999     

糖尿病患者外周血管病变的特征

目的观察糖尿病患者的外周动脉的病变特征。方法采用彩色多普勒超声技术对糖尿病（DM）患者及非糖尿病（N-DM）患者的外周动脉粥样硬化斑块、狭窄以及闭塞性病变特征进行观察。结果与N-DM组比较,DM组外周动脉的内-中膜厚度（IMT）、狭窄血管大小、血管闭塞率、闭塞血管大小及闭塞血管回声差异无统计学意义,但斑块总面积显著增加（P〈0.05）,斑块回声积分显著减小（P〈0.01）,血管狭窄率显著增加（P〈0.01）。结论糖尿病可使患者的外周动脉粥样硬化病变更严重,使中型动脉的狭窄几率更高,但闭塞性病变与非糖尿病患者无差异。     

Diabetic peripheral neuropathy in type 2 diabetes mellitus in Korea

Diabetic peripheral neuropathy (DPN), a common and troublesome complication in patients with type 2 diabetes mellitus (T2DM), contributes to a higher risk of diabetic foot ulcer and lower limb amputation. These situations can negatively impact the quality of life of affected individuals. Despite its high prevalence and clinical importance, most diabetes mellitus patients not only do not recognize the presence of diabetic neuropathy, but also do not report their symptoms to physicians or other health care providers. Therefore, DPN is usually under diagnosed and undertreated. For early detection and appropriate intervention for DPN, a careful history, physical with neurologic examination, and prompt treatment are needed in T2DM patients.     

Value of peripheral artery disease in predicting asymptomatic coronary artery disease in type 2 diabetes mellitus

<正>Objective To investigate the association of peripheral artery disease (PAD) and asymptomatic coronary artery disease (CAD) in type 2 diabetic patients (T2DM)and its predictive value. Methods A total of 365 T2DM who had no CAD history and no symptoms such as chest tightness and chest pain were enrolled. According to the stenosis rate of≥50%or occlusion of any segment of     

Risk factors for peripheral vascular disease in hypertensive subjects with type 2 diabetes mellitus.

Possible factors predisposing to peripheral vascular disease (PVD) in hypertensive subjects with Type 2 diabetes mellitus were studied. Details of age, sex, duration of diabetes, blood pressure, and smoking habit were recorded in 180 subjects of either White, West Indian Black or Asian ethnic origin. Glycosylated haemoglobin, fasting serum total cholesterol, total high density lipoprotein (HDL), HDL2, low density lipoprotein (LDL-cholesterol), and triglycerides were measured in all subjects. Peripheral vascular disease was defined as an ankle/brachial systolic pressure < 1.0 as measured by the Doppler technique. Multivariate analysis was performed and the following factors were identified as being strongly associated with the presence of PVD with a statistical significance of p < 0.001; LDL-cholesterol, total HDL-cholesterol, age, male sex, diet or oral hypoglycaemic therapy, diastolic blood pressure, and of p < 0.003; systolic blood pressure. When blood pressure was excluded from the analysis the other factors retained their predictive value. We conclude that hypertension and dyslipidaemia are important risk factors for peripheral vascular disease in Type 2 diabetes mellitus.     

The ankle-brachial index for assessing the prevalence of peripheral artery disease and cardiovascular risk in patients with type 2 diabetes mellitus

Background and aimsType 2 diabetes mellitus (T2DM) is an important risk factor for peripheral artery disease (PAD). Ankle-Brachial Index (ABI) was found associated with a higher cardiovascular (CV) risk and mortality. The main goals of this study were to establish the prevalence of PAD in a T2DM population, and assess the relationship between PAD and the CV risk calculated with the CUORE Project score (CPS) (https://www.cuore.iss.it/). The association between the ABI, the main risk factors for PAD and T2DM complications was also investigated.Methods and resultsTwo hundred patients were consecutively enrolled. The prevalence of PAD in this population was 17%. The CV risk tended to be higher (p = 0.0712) in the group with a pathological ABI than in the group with a normal ABI. Glycated hemoglobin (r = ?0.1591; p = 0.0244), total cholesterol (r = ?0.1958; p = 0.0054), LDL cholesterol (r = ?0.1708; p = 0.0156) and systolic blood pressure (r = ?0.1523; p = 0.0313) correlated significantly and inversely with the left ABI. The frequency of diabetic retinopathy was significantly higher in the group with a pathological ABI (p = 0.0316).ConclusionsThe data reveal a high prevalence of PAD in patients with T2DM. The CPS confirmed that patients with a pathological ABI have tendency to a higher CV risk. The results point to the importance of an accurate CV assessment – also measuring individuals’ ABI and calculating their CPS - to better pinpoint those at high risk of PAD, especially among patients with T2DM.     

2型糖尿病周围动脉病变与血小板参数关系的研究

目的 观察糖尿病周围动脉病变（PAD）患者中血小板计数、血小板平均体积（MPV）及血小板分布宽度（PDW）的变化情况. 方法 171例T2DM患者根据踝肱指数（ABI）分为重度病变（ABI＜0.4,A）组18例,轻度病变（0.4≤ABI≤0.9,B）组80例,以及正常对照（0.9＜ABI＜1.3,C）组73例,比较3组间BMI、HbA1 c、TC、TG、LDLC、HDL-C、血小板计数、MPV、PDW. 结果 A、B组MPV分别为（13.69±0.57）、（11.22±1.42）,高于C组（9.87±1.62）（P＜0.05）,A组高于B组（F=23.96,P＜0.05）.A、B组PDW分别为（17.14±1.76）、（16.40±3.18）,与C组（23.76±2.76）比较,差异无统计学意义（F=0.18,P=0.83）;A、B组血小板计数分别为（182.12±12.11）、（179.67±15.99）,与C组（177.54±14.87）比较,差异无统计学意义（F=0.23,P=0.79）. 结论 随着PAD的加重,T2DM患者MPV水平升高.     

Diabetic nephropathy: a risk factor for diabetes mellitus in offspring

Summary Both non-insulin-dependent diabetes mellitus and diabetic nephropathy show familial aggregation. If diabetes and renal disease have independent determinants (genetic or otherwise), offspring of parents with diabetic renal disease should have a similar risk of diabetes to those offspring of parents with diabetes alone. To test this hypothesis, the prevalence of diabetes was examined in a population-based pedigree study in Pima Indian offspring of three mutually exclusive parental types: 1) diabetic with renal disease, 2) diabetic, but without renal disease and 3) non-diabetic. Among offspring of one diabetic parent and one non-diabetic parent (n=320) the prevalence of diabetes at ages 15–24 years and 25–34 years was 0% and 11%, respectively if the diabetic parent did not have renal disease compared with 6% and 28% respectively if the diabetic parent did have renal disease. Corresponding rates for offspring of two diabetic parents (n=121) were 10% and 17%, respectively if neither parent had renal disease compared with 30% and 50%, respectively if one parent did have renal disease. The presence of renal disease in a parent with diabetes relative to diabetes alone was associated with 2.5 times the odds of diabetes (95% confidence interval 1.4–4.3) in the offspring controlled for age, age at onset of parental diabetes and diabetes in the other parent using logistic regression. These findings provide support for parental diabetic renal disease, independent of age at onset of parental diabetes, conferring an increased risk for diabetes in the offspring. The results are compatible with the hypothesis that the susceptibility to renal disease in the parents and to diabetes in the offspring are due to shared familial environmental factors or to the same gene or set of genes.Abbreviations NIDDM Non-insulin-dependent diabetes mellitus - ESRD end-stage renal disease     

C-reactive protein and risk factors for peripheral vascular disease in subjects with Type 2 diabetes mellitus.

AIMS: To compare the importance of different inflammatory markers and traditional risk factors in predicting peripheral vascular disease (PVD) in patients with Type 2 diabetes mellitus. METHODS: A cross-sectional analysis of 30 Type 2 diabetic patients with PVD defined by ankle-brachial index (ABI) < 0.9, and 60 Type 2 diabetic patients without PVD (ABI > 1.0). Overnight blood was drawn and sent for study. RESULTS: Longer diabetic duration (15 +/- 8 vs. 10 +/- 7 years, P = 0.007), higher serum creatinine level (0.11 +/- 0.04 vs. 0.09 +/- 0.03 mmol/l, P = 0.001), higher total cholesterol/high-density lipoprotein-cholesterol (TC/HDL-C) ratio (5.2 +/- 1.6 vs. 4.3 +/- 1.1, P = 0.004) and increased hypertension status (70% vs. 52%, P = 0.014) and cerebral infarction (CI) history (23% vs. 3%, P = 0.009) were noted in Type 2 diabetes with PVD. Those with PVD also showed significantly higher serum levels of C-reactive protein (CRP) (median 0.282 vs. 0.102 mg/dl, P < 0.001) and interleukin (IL)-6 (10.6 +/- 1.81 vs 1.6 +/- 4.6 pg/ml, P = 0.001). Multivariate regression analysis showed that higher serum levels of C-reactive protein (CRP), longer diabetic duration, and use of angiotensin converting enzyme inhibitor (ACEI) were independently associated with PVD in Type 2 diabetes mellitus. CONCLUSIONS: Type 2 diabetic patients with PVD had longer diabetic duration, higher serum creatinine levels, higher TC/HDL-C ratio, higher hypertension and CI history and higher CRP and IL-6 levels. Only serum CRP level, diabetic duration, and use of ACEI were independently associated with PVD in Type 2 diabetes mellitus.     

2型糖尿病家系发病特征与危险因素初步调查

Objective To explore the characteristics and risk factors of type 2 diabetes mellitus (T2DM) onset in pedigrees. Methods A total of 865 subjects were screened and diagnosed by oral glucose tolerance test (OGTT) based on American Diabetes Association (ADA) criteria. Type 1 diabetes mellitus (T1DM) , maturity onset diabetes of the young (MODY) and chondriosome diabetes were excluded by clinical features and laboratory test of insulin and autoantibodies including glutamic acid decarboxylase antibody, insular cellular antibody and insulin autoantibody. A total of 182 pedigrees of T2DM were obtained. Results No gender difference was found in the prevalence of T2DM (42. 59% in male and 48. 18% in female respectively, P ＞0. 05) , nor was the newly diagnosed rate(9. 89% in male and 11. 82%in female, P ＞ 0. 05). The onset age was (63. 3 ± 12. 4) years old in the first generation [(64. 4 ± 12. 5)years in male and (62. 3 ± 10. 3) years in female] , (47. 1 ± 8. 7) years old in the second generation [(48. 2 ±9. 3)years in male and (46. 1 ± 8. 1) years in female] , (29. 6 ± 10. 2) years old in the third generation [(28. 9 ±9. 5)years in male and (30. 0 ± 10. 4)years in female]. Compared with normal glucose tolerance (NGT) subjects , newly diagnosed T2DM and impaired glucose regulation (IGR) subjects had higher prevalence of hypertension, hyperlipidemia and smoking but less physical activities. Statistical differences were shown in body weight five years before diagnosis, one years before diagnosis and at diagnosis in newly diagnosed T2DM[(68. 4 ±12. 4)kg, (69. 5 ± 11. 0)kg and (69. 1 ±9. 6)kg] and IGR[(66. 1 ±10.7)kg, (65.9 ± 10.7) kg and(65.7 ± 10.4) kg] , when compared with NGT [(61.0 ± 10.2) kg,(59. 5 ±11.0) kg and (60. 1 ± 10. 4) kg, all P ＜ 0. 05] . The same results were obtained with waist circumference and waist-hip ratio [(4. 1 ± 12. 5) cm and 0. 92 ± 0. 36 in newly diagnosed T2DM while (89. 1 ± 10. 7) cm and 0. 90 ± 0. 64 in IGR] , when compared with NGT[(82. 5 ± 10. 1) cm and 0. 82 ±0. 25] , all P ＜0. 05. Conclusions No gender difference was found in the onset characteristics of T2DM.High prevalence of obesity, hypertension, hyperlipidemia and smoking with less physical activities were associated with T2DM.     

2型糖尿病家系发病特征与危险因素初步调查

目的 对2型糖尿病家系中的遗传特征、危险因素进行调查分析,为系统研究2型糖尿病及制定干预措施提供依据.方法 根据1997年美国糖尿病学会(ADA)标准,利用口服葡萄糖耐量试验确诊糖尿病,根据胰岛素功能测定和血清谷氨酸脱羧酶抗体(GADAb)、胰岛细胞抗体(ICA)和胰岛素自身抗体(IAA)检测及临床特征排除1型糖尿病,根据遗传特征及临床特点排除年轻的成年发病型糖尿病(MODY),根据母系遗传伴耳聋等临床特征排除线粒体基因突变家系,最终筛选出2型糖尿病家系182个(实际调查865例)并进行分析.结果 182个家系中男女2型糖尿病患病率(男性42.59%、女性48.18%)、新诊断率(男性9.89%、女性1 1.82%)差异无统计学意义(P＞0.05).家系第1代277例患者发病年龄为(63.3±12.4)岁,其中男性为(64.4±12.5)岁,女性为(62.3±10.3)岁;第2代468例患者发病年龄为(47.1 ±8.7)岁,其中男性为(48.2±9.3)岁,女性为(46.1±8.1)岁;第3代120例患者发病年龄为(29.6±10.2)岁,其中男性为(28.9 ±9.5)岁,女性为(30.0±10.4)岁.新诊断2型糖尿病组、新诊断糖调节受损(IGR)组分别与非患病亲属组比较,高血压病史、高脂血症史、吸烟史、活动量差异均有统计学意义;5年前体重、1年前体重、目前体重、腰围、腰臀比差异也有统计学意义,股围差异无统计学意义.结论 2型糖尿病发病无性别差异.肥胖、高血压病、吸烟、高脂血症、活动量较少与2型糖尿病、IGR相关.活动量较多可能是家族中的非患病亲属及IGR患者较晚进入糖尿病期的原因之一.

Abstract：

Objective To explore the characteristics and risk factors of type 2 diabetes mellitus (T2DM) onset in pedigrees. Methods A total of 865 subjects were screened and diagnosed by oral glucose tolerance test (OGTT) based on American Diabetes Association (ADA) criteria. Type 1 diabetes mellitus (T1DM) , maturity onset diabetes of the young (MODY) and chondriosome diabetes were excluded by clinical features and laboratory test of insulin and autoantibodies including glutamic acid decarboxylase antibody, insular cellular antibody and insulin autoantibody. A total of 182 pedigrees of T2DM were obtained. Results No gender difference was found in the prevalence of T2DM (42. 59% in male and 48. 18% in female respectively, P ＞0. 05) , nor was the newly diagnosed rate(9. 89% in male and 11. 82%in female, P ＞ 0. 05). The onset age was (63. 3 ± 12. 4) years old in the first generation [(64. 4 ± 12. 5)years in male and (62. 3 ± 10. 3) years in female] , (47. 1 ± 8. 7) years old in the second generation [(48. 2 ±9. 3)years in male and (46. 1 ± 8. 1) years in female] , (29. 6 ± 10. 2) years old in the third generation [(28. 9 ±9. 5)years in male and (30. 0 ± 10. 4)years in female]. Compared with normal glucose tolerance (NGT) subjects , newly diagnosed T2DM and impaired glucose regulation (IGR) subjects had higher prevalence of hypertension, hyperlipidemia and smoking but less physical activities. Statistical differences were shown in body weight five years before diagnosis, one years before diagnosis and at diagnosis in newly diagnosed T2DM[(68. 4 ±12. 4)kg, (69. 5 ± 11. 0)kg and (69. 1 ±9. 6)kg] and IGR[(66. 1 ±10.7)kg, (65.9 ± 10.7) kg and(65.7 ± 10.4) kg] , when compared with NGT [(61.0 ± 10.2) kg,(59. 5 ±11.0) kg and (60. 1 ± 10. 4) kg, all P ＜ 0. 05] . The same results were obtained with waist circumference and waist-hip ratio [(4. 1 ± 12. 5) cm and 0. 92 ± 0. 36 in newly diagnosed T2DM while (89. 1 ± 10. 7) cm and 0. 90 ± 0. 64 in IGR] , when compared with NGT[(82. 5 ± 10. 1) cm and 0. 82 ±0. 25] , all P ＜0. 05. Conclusions No gender difference was found in the onset characteristics of T2DM.High prevalence of obesity, hypertension, hyperlipidemia and smoking with less physical activities were associated with T2DM.     

2型糖尿病家系发病特征与危险因素初步调查

Objective To explore the characteristics and risk factors of type 2 diabetes mellitus (T2DM) onset in pedigrees. Methods A total of 865 subjects were screened and diagnosed by oral glucose tolerance test (OGTT) based on American Diabetes Association (ADA) criteria. Type 1 diabetes mellitus (T1DM) , maturity onset diabetes of the young (MODY) and chondriosome diabetes were excluded by clinical features and laboratory test of insulin and autoantibodies including glutamic acid decarboxylase antibody, insular cellular antibody and insulin autoantibody. A total of 182 pedigrees of T2DM were obtained. Results No gender difference was found in the prevalence of T2DM (42. 59% in male and 48. 18% in female respectively, P ＞0. 05) , nor was the newly diagnosed rate(9. 89% in male and 11. 82%in female, P ＞ 0. 05). The onset age was (63. 3 ± 12. 4) years old in the first generation [(64. 4 ± 12. 5)years in male and (62. 3 ± 10. 3) years in female] , (47. 1 ± 8. 7) years old in the second generation [(48. 2 ±9. 3)years in male and (46. 1 ± 8. 1) years in female] , (29. 6 ± 10. 2) years old in the third generation [(28. 9 ±9. 5)years in male and (30. 0 ± 10. 4)years in female]. Compared with normal glucose tolerance (NGT) subjects , newly diagnosed T2DM and impaired glucose regulation (IGR) subjects had higher prevalence of hypertension, hyperlipidemia and smoking but less physical activities. Statistical differences were shown in body weight five years before diagnosis, one years before diagnosis and at diagnosis in newly diagnosed T2DM[(68. 4 ±12. 4)kg, (69. 5 ± 11. 0)kg and (69. 1 ±9. 6)kg] and IGR[(66. 1 ±10.7)kg, (65.9 ± 10.7) kg and(65.7 ± 10.4) kg] , when compared with NGT [(61.0 ± 10.2) kg,(59. 5 ±11.0) kg and (60. 1 ± 10. 4) kg, all P ＜ 0. 05] . The same results were obtained with waist circumference and waist-hip ratio [(4. 1 ± 12. 5) cm and 0. 92 ± 0. 36 in newly diagnosed T2DM while (89. 1 ± 10. 7) cm and 0. 90 ± 0. 64 in IGR] , when compared with NGT[(82. 5 ± 10. 1) cm and 0. 82 ±0. 25] , all P ＜0. 05. Conclusions No gender difference was found in the onset characteristics of T2DM.High prevalence of obesity, hypertension, hyperlipidemia and smoking with less physical activities were associated with T2DM.     

79例糖尿病肾病五年随访分析

目的分析影响糖尿病肾病0DN)五年肾存活率的主要因素.方法调查了79例DN的临床、实验室及治疗有关资料,对各项临床参数进行单因素及多因素相关分析.结果蛋白尿程度较重0≥1.5g/24h),血肌酐升高0≥120umol/L),内生肌酐清除率下降0＜50ml/min)及血糖和血压控制不良对五年肾存活具有不良影响.结论严格控制血压,采取有效措施减轻肾脏受损程度,并及早控制血糖是提高肾存活率的关键.     

2型糖尿病家系发病特征与危险因素初步调查

Objective To explore the characteristics and risk factors of type 2 diabetes mellitus (T2DM) onset in pedigrees. Methods A total of 865 subjects were screened and diagnosed by oral glucose tolerance test (OGTT) based on American Diabetes Association (ADA) criteria. Type 1 diabetes mellitus (T1DM) , maturity onset diabetes of the young (MODY) and chondriosome diabetes were excluded by clinical features and laboratory test of insulin and autoantibodies including glutamic acid decarboxylase antibody, insular cellular antibody and insulin autoantibody. A total of 182 pedigrees of T2DM were obtained. Results No gender difference was found in the prevalence of T2DM (42. 59% in male and 48. 18% in female respectively, P ＞0. 05) , nor was the newly diagnosed rate(9. 89% in male and 11. 82%in female, P ＞ 0. 05). The onset age was (63. 3 ± 12. 4) years old in the first generation [(64. 4 ± 12. 5)years in male and (62. 3 ± 10. 3) years in female] , (47. 1 ± 8. 7) years old in the second generation [(48. 2 ±9. 3)years in male and (46. 1 ± 8. 1) years in female] , (29. 6 ± 10. 2) years old in the third generation [(28. 9 ±9. 5)years in male and (30. 0 ± 10. 4)years in female]. Compared with normal glucose tolerance (NGT) subjects , newly diagnosed T2DM and impaired glucose regulation (IGR) subjects had higher prevalence of hypertension, hyperlipidemia and smoking but less physical activities. Statistical differences were shown in body weight five years before diagnosis, one years before diagnosis and at diagnosis in newly diagnosed T2DM[(68. 4 ±12. 4)kg, (69. 5 ± 11. 0)kg and (69. 1 ±9. 6)kg] and IGR[(66. 1 ±10.7)kg, (65.9 ± 10.7) kg and(65.7 ± 10.4) kg] , when compared with NGT [(61.0 ± 10.2) kg,(59. 5 ±11.0) kg and (60. 1 ± 10. 4) kg, all P ＜ 0. 05] . The same results were obtained with waist circumference and waist-hip ratio [(4. 1 ± 12. 5) cm and 0. 92 ± 0. 36 in newly diagnosed T2DM while (89. 1 ± 10. 7) cm and 0. 90 ± 0. 64 in IGR] , when compared with NGT[(82. 5 ± 10. 1) cm and 0. 82 ±0. 25] , all P ＜0. 05. Conclusions No gender difference was found in the onset characteristics of T2DM.High prevalence of obesity, hypertension, hyperlipidemia and smoking with less physical activities were associated with T2DM.     

2型糖尿病及糖尿病肾病危险因素分析

目的 研究2型糖尿病（DM）及糖尿病肾病（DN）的易患因素，指导临床及早防治。方法 随机选择2型糖尿病病例201例，人群对照110例作病例对照研究。根据尿白蛋白排泄率（UAER）将DM患者分为四组互为对照比较。结果 与人群对照组相比，DM组在饮酒、喜食甜食、过多摄入动物脂肪、糖尿病家族史、女性病人巨大儿生产史、合并冠心病、高血压、脑血管意外、高脂血症、胰岛素敏感性指标方面有显著差异。DM四组间在年龄、病程、继发糖尿病眼病、糖尿病神经病变、合并高血压、冠心病、脑血管意外、胆囊结石、心电图异常、收缩压、舒张压有显著差异。UAER与糖尿病肾病、眼病、冠心病正相关。结论 饮酒、喜食甜食、过多摄入动物脂肪、糖尿病家族史、女性病人巨大儿生产史、合并冠心病、高血压、脑血管意外、高脂血症、胰岛素抵抗等可能是2型糖尿病的危险因素。血糖、血脂、血压的不良控制导致糖尿病肾病的进展，DN与其他血管并发症或合并症有较好的相关性。定期监测尿白蛋白排泄率对于及早发现防治糖尿病肾病和其它血管并发症具有重要意义。     

Silent coronary artery disease in patients with type 2 diabetes mellitus

Abstract. The purpose of this study was to estimate the prevalence and risk factors of silent CAD in asymptomatic type 2 diabetic patients aged over 40 years. A total of 172 asymptomatic type 2 diabetic patients, mean age 54.42 years, with normal resting electrocardiogram were included in the study. Technetium-99m (Tc-99m) tetrofosmin cardiac single photon emission computed tomography myocardial scintigraphy with exercise testing or dipyridamole injection was performed on all patients. If this test was positive, coronary angiography was carried out and was considered to be positive with a stenosis of 70%. Abnormal perfusion pattern was found in 14 patients (8.14%). Significant coronary artery stenosis was found in 13 subjects (7.56%), confirming a high positive predictive value (92.86%) of this diagnostic procedure. A significant correlation was observed between silent CAD and male sex, retinopathy, hypertension, post-prandial blood glucose level, and low HDL-cholesterol level. Sex (OR=4.026; 95% CI, 1.187–13.659), hypertension (OR=5.564; 95% CI, 1.446–21.400) and retinopathy (OR=3.766; 95% CI, 1.096–12.948) were risk factors for CAD. Overall, 14.06% of asymptomatic male patients with type 2 diabetes mellitus presented silent CAD with significant angiographically documented coronary stenosis. This finding, along with the high positive predictive value of a noninvasive technique, indicates that routine screening for silent CAD would be useful in this patient subgroup especially when they have retinopathy or hypertension.