摘要
目的研究早发2型糖尿病(T2DM)的临床特征,探讨其慢性并发症的相关危险因素。方法 2713例病程皆在10年之内的 T2DM 患者,根据发病年龄是否大于40岁分为早发(EOD)和晚发组(LOD)。比较两组的临床资料,分析 EOD 患者的临床特征及慢性并发症的相关危险因素。结果(1)与 LOD 组相比,EOD 组吸烟者比例较高(29.2%vs22.0%,P<0.01),糖尿病家族史阳性率增高(28.6%vs13.1%,P<0.01),血糖(FPG 及 HbAlc)控制不佳者比例高(分别为80.8%vs74.6%及77.3%vs72.7%,均 P<0.05),血 TG(2.5±2.4mmol/L vs 1.9±1.5 mmol/L,P<0.01)及 BMI(24.4kg/m^2±4.6 kg/m^2vs 23.6 kg/m^2±3.7 kg/m^2,P<0.01)水平高。EOD 组代谢综合征(MS)的患病率高于 LOD 组(18.9%vs10.7%,P<0.01)。(2)EOD 组患者的微血管及神经并发症发生率高于其大血管并发症,且早发患者的疼痛(10.6%vs7.10%,P<0.05),感觉缺失(6.20%vs2.80%,P<0.01),腹泻(6.00%vs3.70%,P<0.05)等神经并发症发生率及早期肾病发生率(13.00%vs8.00%,P<0.01)高于 LOD 组。多因素 Logistic 回归分析提示,年龄、病程、高血压、吸烟、阳性家族史、高 TG 血症是慢性并发症发生发展的重要相关因素。结论 EOD 患者表现有更严重的代谢紊乱,相对易早期并发各种微血管、神经的损害,而晚发 T2DM 患者更易并发心脑血管病、高血压病等大血管病变。多因素综合防治策略是防治其慢性并发症发生发展的重要措施。
Objective To investigate the clinical characteristics of early-onset type 2 diabetes (EOD) and the risk factors associated with its chronic complications. Methods A total of 2713 T2DM patients were recruited and divided into two groups: early-and late-onset groups EOD group (diagnosed at the age ≤ 40 ) and late-onset type 2 diabetes (LOD) group (diagnosed at the age 〉 40 ). The clinical characteristics were compared between two groups, and the risk factors were analyses within the early-onset group. Results (1) The EOD patients were characterized by significantly higher levels of triglycerides ( 2. 5 ± 2.4 mmol/L vs 1.9 ± 1.5 mmol/L, P 〈 0.01 ) and BMI ( 24.4 kg/m^2 ± 4.6 kg/m^2 vs 23.6 kg/m^2 ± 3.7 kg/m^2, P 〈 0.01 ), higher rates of smoking (29.2% vs 22.0%, P 〈 0.01 ), family history of diabetes (28.6% vs 13.1%, P 〈0.01 ), and higher prevalence of metabolic syndrome ( 18.9% vs 10.7% , P 〈 0. 01), higher proportion of patients with unacceptable HbAlc ( 〉7.0% ) (77.3% versus 72.7%, P 〈 0. 05 ) and fasting blood glucose ≥7.0 mmol/L, (80.8 % versus 74.6%, P 〈 0. 05 ). (2) The prevalence rates of microvascular complications were higher than those of macrovascular complications in the EOD group, and the prevalence rates of pain, anesthesia, diarrhea, and nephropathy were 10.6% , 6.20%, 6. 00%, and 13.00% respectively, all significantly higher than those of the LOD group (7.10% , 2.80%, 3.70%, and 8.00% respectively, P 〈 0.05, 〈 0.01, 〈 0.05, and 〈 0.01 ). Linear regression analysis showed that certain subsets of chronic complications were associated with onset age, diabetes duration, hypertension, family history and high level of triglyceride. Conclusion Early-onset DM patients present the clinical features of poorer metabolic profiles, which may contribute to the development of certain subsets of microvascular complications. Late-onset patients tend to be complicated with macmvascular diseases, such as cerebrovascular disease, angiocardiopathy, etc. Multiple factor comprehensive control is important for the prevention of the complications.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2006年第36期2547-2551,共5页
National Medical Journal of China
关键词
糖尿病
非胰岛素依赖型
并发症
Diabetes mellitus, non insulin dependent
Chronic complications