Williams K V, Erbey J R, Becker D, Orchard T J
Division of Endocrinology and Metabolism, School of Medicine, Children's Hospital of Pittsburgh, Pennsylvania, USA.
Diabetes Care. 1999 Jul;22(7):1084-91. doi: 10.2337/diacare.22.7.1084.
To assess the prevalence and incidence of being overweight in type 1 diabetes, to identify factors associated with weight gain and improved glycemic control, and to examine relationships among weight gain, glycemic control, and cardiovascular risk factors.
The prevalence and incidence of being overweight in the Pittsburgh Epidemiology of Diabetes Complications (EDC) cohort (n = 441) were compared with the general population (National Health and Nutrition Examination Survey [NHANES]). Factors associated with weight gain and improved glycemic control were identified, and relationships among weight gain, glycemic control, and cardiovascular risk factors were examined over a 6.9 +/- 2.2-year period.
At baseline, the prevalence of being overweight (BMI > 27.8 kg/m2 for men and > 27.3 kg/m2 for women) was 10.4 and 11.4%, respectively, and was lower than the age- and sex-specific estimate for the general population (P < 0.05). The incidence of being overweight was comparable in men (12.6%) and women (11.8%) and did not differ from the general population (P = 0.98). Weight gain correlated with improvements in HbA1c (r = -0.21, P < 0.001). Patients with the highest baseline HbA1c levels gained the most weight and had the greatest improvement in glycemic control. A lower baseline BMI was also associated with a greater improvement in glycemic control. Weight gain favorably influenced the lipid profile in the setting of improved glycemic control, but adversely influenced the lipid profile in the absence of improved glycemic control. Weight change was directly associated with blood pressure change, but the incidence of hypertension was more strongly influenced by the development of nephropathy.
The prevalence of being overweight in type 1 diabetes remains lower than that in the general population. Moderate weight gain did not adversely affect the cardiovascular risk profile in the setting of improved glycemic control.
评估1型糖尿病患者超重的患病率和发病率，确定与体重增加及血糖控制改善相关的因素，并研究体重增加、血糖控制和心血管危险因素之间的关系。
将匹兹堡糖尿病并发症流行病学（EDC）队列（n = 441）中超重的患病率和发病率与一般人群（国家健康与营养检查调查[NHANES]）进行比较。确定与体重增加及血糖控制改善相关的因素，并在6.9±2.2年的时间内研究体重增加、血糖控制和心血管危险因素之间的关系。
在基线时，超重（男性BMI>27.8 kg/m²，女性BMI>27.3 kg/m²）的患病率分别为10.4%和11.4%，低于一般人群按年龄和性别划分的估计值（P<0.05）。超重的发病率在男性（12.6%）和女性（11.8%）中相当，与一般人群无差异（P = 0.98）。体重增加与糖化血红蛋白（HbA1c）的改善相关（r = -0.21，P<0.001）。基线HbA1c水平最高的患者体重增加最多，血糖控制改善最大。较低的基线BMI也与血糖控制的更大改善相关。在血糖控制改善的情况下，体重增加对血脂谱有有利影响，但在血糖控制未改善的情况下对血脂谱有不利影响。体重变化与血压变化直接相关，但高血压的发病率受肾病发展的影响更大。
1型糖尿病患者超重的患病率仍低于一般人群。在血糖控制改善的情况下，适度的体重增加对心血管风险状况没有不利影响。
