Banerjea Ranjana, Sambamoorthi Usha, Weaver Frances, Maney Miriam, Pogach Leonard M, Findley Thomas
Department of Veteran Affairs, Health Services Research and Development Service Center for Health Care Knowledge and Management, East Orange, NJ 07018, USA.
Arch Phys Med Rehabil. 2008 Aug;89(8):1448-53. doi: 10.1016/j.apmr.2007.12.047.
To compare the rates of diabetes and macrovascular conditions in veterans with spinal cord injury (SCI) and to examine variations by patient-level demographic, socioeconomic, access, and health status factors.
A retrospective analysis. Diabetes status was classified by merging with diabetes epidemiology cohort using a validated algorithm. Chi-square tests and logistic regressions used to compare rates in macro- and microvascular conditions in veterans with and without diabetes.
Veteran Health Administration clinic users in fiscal year (FY) 1999 to FY 2001.
SCI patients (N=8769) with diabetes (n=1333), in FY 2000, identified through the SCI registry.
Not applicable.
Macrovascular and microvascular conditions in the next year (February 2001). Derived from International Statistical Classification of Diseases, 9th Revision, Clinical Modification, codes in the patient treatment files.
Overall, 15% of SCI veterans were identified with diabetes but this was an underestimate due to high mortality (8%). Among SCI veterans with diabetes, 49% had at least one macrovascular condition and 54% had microvascular conditions compared with 24% and 25% of those without diabetes (P<.001).
Our study highlights the highly significant relationship between diabetes and macro- and microvascular conditions in veterans with SCI. Neurologic deficit combined with increased insulin resistance has a greater macrovascular impact on SCI veterans than on those who do not have diabetes. Increasing age and physical comorbidities compound the problem.
比较脊髓损伤（SCI）退伍军人的糖尿病和大血管疾病发生率，并研究患者层面的人口统计学、社会经济、就医机会和健康状况因素导致的差异。
一项回顾性分析。通过使用经过验证的算法与糖尿病流行病学队列合并来分类糖尿病状态。采用卡方检验和逻辑回归来比较有糖尿病和无糖尿病退伍军人的大血管和微血管疾病发生率。
1999财年至2001财年退伍军人健康管理局诊所的使用者。
2000财年通过SCI登记处识别出的患有糖尿病的SCI患者（N = 8769），其中糖尿病患者为1333例。
不适用。
次年（2001年2月）的大血管和微血管疾病情况。源自《国际疾病分类，第9版，临床修订本》，患者治疗档案中的编码。
总体而言，15%的SCI退伍军人被诊断患有糖尿病，但由于高死亡率（8%），这是一个低估数字。在患有糖尿病的SCI退伍军人中，49%至少有一种大血管疾病，54%有微血管疾病，而无糖尿病的退伍军人中这一比例分别为24%和25%（P<0.001）。
我们的研究突出了SCI退伍军人中糖尿病与大血管和微血管疾病之间的高度显著关系。神经功能缺损与胰岛素抵抗增加相结合，对SCI退伍军人的大血管影响比对无糖尿病者更大。年龄增长和身体合并症使问题更加复杂。
