Shiraiwa Toshihiko, Kaneto Hideaki, Miyatsuka Takeshi, Kato Ken, Yamamoto Kaoru, Kawashima Ayaha, Kanda Tsutomu, Suzuki Masaaki, Imano Eiichi, Matsuhisa Munehide, Hori Masatsugu, Yamasaki Yoshimitsu
Department of Internal Medicine and Therapeutics (A8), Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka 565-0871, Japan.
Biochem Biophys Res Commun. 2005 Oct 14;336(1):339-45. doi: 10.1016/j.bbrc.2005.08.158.
Diabetic microangiopathy is often observed in diabetic patients, but there is little evidence regarding the relationship between post-prandial glycemia or insulinemia and the incidence of diabetic microangiopathy. In this study, to elucidate the relationship between post-prandial glycemia (or insulinemia) and diabetic microangiopathy, we performed a cross-sectional study of 232 subjects with type 2 diabetes mellitus who were not being treated with insulin injections. A multiple regression analysis showed that post-prandial hyperglycemia independently correlated with the incidence of diabetic retinopathy and neuropathy. Post-prandial hyperglycemia also correlated, although not independently, with the incidence of diabetic nephropathy. In addition, interestingly, post-prandial hypoinsulinemia independently correlated with the incidence of diabetic retinopathy, although not correlated with diabetic neuropathy or nephropathy. In conclusion, post-prandial hyperglycemia, rather than fasting glycemia or hemoglobin A1c levels, is an important predictor of the incidence of diabetic microangiopathy in Japanese type 2 diabetic patients.
糖尿病微血管病变在糖尿病患者中较为常见，但关于餐后血糖或胰岛素血症与糖尿病微血管病变发生率之间的关系，相关证据较少。在本研究中，为阐明餐后血糖（或胰岛素血症）与糖尿病微血管病变之间的关系，我们对232例未接受胰岛素注射治疗的2型糖尿病患者进行了一项横断面研究。多元回归分析显示，餐后高血糖与糖尿病视网膜病变和神经病变的发生率独立相关。餐后高血糖与糖尿病肾病的发生率也相关，尽管并非独立相关。此外，有趣的是，餐后低胰岛素血症与糖尿病视网膜病变的发生率独立相关，尽管与糖尿病神经病变或肾病无关。总之，对于日本2型糖尿病患者，餐后高血糖而非空腹血糖或糖化血红蛋白水平是糖尿病微血管病变发生率的重要预测指标。
