代谢综合征的流行情况及其对印度 2 型糖尿病患者微血管并发症的影响。Sankara Nethralaya 糖尿病视网膜病变流行病学和分子遗传学研究（SN-DREAMS，报告 14）。
Prevalence of Metabolic Syndrome and its influence on microvascular complications in the Indian population with Type 2 Diabetes Mellitus. Sankara Nethralaya Diabetic Retinopathy Epidemiology And Molecular Genetic Study (SN-DREAMS, report 14).
机构信息
Shri Bhagwan Mahavir Vitreoretinal Services, 18, College Road, Sankara Nethralaya, Chennai-600 006, Tamil Nadu, India.
出版信息
Diabetol Metab Syndr. 2010 Nov 11;2:67. doi: 10.1186/1758-5996-2-67.
BACKGROUND
The Metabolic syndrome (MS) consists of central obesity, glucose intolerance, hyperinsulinemia, low high density lipoproteins, high triglycerides and hypertension. Different studies have observed that MS causes microvascular complications in patients with type 2 diabetes. The aim of the study was to find out the prevalence of MS in the Indian population with type 2 diabetes mellitus in relation to gender, duration of diabetes, and to evaluate the influence of MS and its individual components on microvascular complications such as diabetic retinopathy, diabetic nephropathy and diabetic neuropathy.
METHODS
A population-based cross sectional survey was conducted with 1414 patients having type 2 diabetes mellitus. The International Diabetes Federation (IDF) criteria were used to identify the metabolic syndrome. Diabetic retinopathy was graded using the stereoscopic digital fundus photography. Neuropathy was assessed by measuring the vibration perception threshold through a sensitometer. Nephropathy was diagnosed by the presence of microalbuminuria in the first morning urine sample.
RESULTS
The age and gender adjusted prevalence of MS, using the IDF criteria, in the South Indian population was 73.3%. The prevalence was higher in women (83.3%), compared to men (65.3%). In subjects with diabetes mellitus, without and with MS, the prevalence of retinopathy was 21.3% and 16.9% (p = 0.057); prevalence of nephropathy was 20.5% and 18.0% (p = 0.296), and prevalence of neuropathy was17.2% and 19.4% (p = 0.353) respectively. Overall and in women, the clustering of MS components led to an increase in the prevalence of diabetic nephropathy. The prevalence of retinopathy and neuropathy in MS subjects, who had diabetes for < 10 years, was more in both men and women; it was more in women but not in men when the duration of diabetes varied from 11-20 years.
CONCLUSIONS
The association of MS with microangiopathies decreased with an increase in the duration of diabetes. MS behaved differently in men and women. It may need to be managed differently in the two groups.
背景
代谢综合征（MS）由中心性肥胖、葡萄糖耐量受损、高胰岛素血症、低高密度脂蛋白、高甘油三酯和高血压组成。不同的研究表明，MS 会导致 2 型糖尿病患者发生微血管并发症。本研究旨在了解 2 型糖尿病印度人群中 MS 的患病率与性别、糖尿病病程的关系，并评估 MS 及其各组分对糖尿病视网膜病变、糖尿病肾病和糖尿病神经病变等微血管并发症的影响。
方法
对 1414 例 2 型糖尿病患者进行了一项基于人群的横断面调查。采用国际糖尿病联合会（IDF）标准来确定代谢综合征。使用立体数字眼底摄影来分级糖尿病视网膜病变。通过使用振动感觉阈值计来评估神经病。通过测量晨尿中的微量白蛋白来诊断肾病。
结果
在南印度人群中，使用 IDF 标准，年龄和性别调整后的 MS 患病率为 73.3%。女性（83.3%）的患病率高于男性（65.3%）。在无 MS 和有 MS 的糖尿病患者中，视网膜病变的患病率分别为 21.3%和 16.9%（p=0.057）；肾病的患病率分别为 20.5%和 18.0%（p=0.296），神经病的患病率分别为 17.2%和 19.4%（p=0.353）。总体而言，在女性中，MS 组分的聚集导致糖尿病肾病患病率增加。病程<10 年的 MS 患者中，视网膜病变和神经病的患病率在男性和女性中均更高；在病程为 11-20 年的女性中，患病率更高，但在男性中则不然。
结论
MS 与微血管病变的相关性随着糖尿病病程的延长而降低。MS 在男性和女性中的表现不同。可能需要在这两个群体中进行不同的管理。
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