Morrish N J, Stevens L K, Fuller J H, Jarrett R J, Keen H
Unit for Metabolic Medicine, United Medical School, London.
Diabetologia. 1991 Aug;34(8):590-4. doi: 10.1007/BF00400279.
We have examined the relationship between baseline variables and the incidence of new macrovascular complications amongst the 497 members of the London cohort of the WHO Multinational Study of Vascular Disease in Diabetics over a mean 8.33-year follow-up. In univariate logistic regression analysis the incidence of new ischaemic electrocardiographic abnormality was significantly associated with systolic and diastolic blood pressure, diabetes duration and hypertension in patients with insulin-dependent diabetes, and with smoking in patients with non-insulin-dependent diabetes. New myocardial infarction was associated with systolic blood pressure, plasma cholesterol, proteinuria and smoking in patient with non-insulin-dependent diabetes; there were no significant associations among patients with insulin-dependent diabetes. All new ischaemic heart disease was associated with hypertension in patients with insulin-dependent diabetes, and plasma cholesterol and smoking in patients with non-insulin-dependent diabetes. New cerebrovascular disease was associated with systolic and diastolic blood pressure, ECG abnormality and hypertension. New peripheral vascular disease was associated with smoking. Multivariate analysis showed the following significant associations 1) in patients with insulin-dependent diabetes: ECG abnormality; hypertension, myocardial infarction; smoking, ischaemic heart disease; hypertension, diabetes duration and smoking, 2) in patients with non-insulin-dependent diabetes: ECG abnormality; smoking, myocardial infarction; serum cholesterol, proteinuria and smoking ischaemic heart disease; smoking. For new cerebrovascular disease, proteinuria and ECG abnormality were significant predictors in multivariate analysis. Patients with diabetes share many of the established risk factors for nondiabetic subjects, in addition proteinuria may be of significance in the prediction of macrovascular disease in diabetes.
我们在世界卫生组织糖尿病患者血管疾病多国研究伦敦队列的497名成员中，进行了平均8.33年的随访，研究了基线变量与新的大血管并发症发生率之间的关系。在单因素逻辑回归分析中，胰岛素依赖型糖尿病患者新出现的缺血性心电图异常发生率与收缩压和舒张压、糖尿病病程及高血压显著相关，非胰岛素依赖型糖尿病患者则与吸烟显著相关。非胰岛素依赖型糖尿病患者新发心肌梗死与收缩压、血浆胆固醇、蛋白尿及吸烟相关；胰岛素依赖型糖尿病患者之间无显著相关性。所有新发缺血性心脏病在胰岛素依赖型糖尿病患者中与高血压相关，在非胰岛素依赖型糖尿病患者中与血浆胆固醇及吸烟相关。新发脑血管疾病与收缩压和舒张压、心电图异常及高血压相关。新发外周血管疾病与吸烟相关。多因素分析显示以下显著相关性：1）胰岛素依赖型糖尿病患者：心电图异常；高血压、心肌梗死；吸烟、缺血性心脏病；高血压、糖尿病病程及吸烟；2）非胰岛素依赖型糖尿病患者：心电图异常；吸烟、心肌梗死；血清胆固醇、蛋白尿及吸烟、缺血性心脏病；吸烟。对于新发脑血管疾病，蛋白尿和心电图异常在多因素分析中是显著预测因素。糖尿病患者与非糖尿病患者有许多共同的既定危险因素，此外，蛋白尿在糖尿病大血管疾病的预测中可能具有重要意义。
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