Del Cañizo Gómez Francisco Javier, Fernández Pérez Cristina, Moreno Ruiz Inmaculada, de Gorospe Pérez-Jáuregui Carlos, Silveira Rodríguez Belén, González Losada Tomás, Segura Galindo Amparo
Section of Endocrinology and Nutrition, Hospital Universitario Infanta Leonor, School of Medicine, Universidad Complutense, Madrid, Spain.
Endocrinol Nutr. 2011 Apr;58(4):163-8. doi: 10.1016/j.endonu.2011.01.006. Epub 2011 Mar 15.
To conduct a prospective study in patients with type 2 diabetes mellitus (T2DM) with no microvascular complications, analyzing the association between various baseline risk factors and development of microvascular complications at follow-up.
A prospective, observational study in 376 patients with T2DM enrolled in 2004. The clinical end-point was urinary albumin excretion (UAE) > 30mg/24h and/or presence of retinopathy at follow-up in 2007. Baseline variables included age, gender, duration of T2DM, fasting plasma glucose, glycated hemoglobin (HbA(1c)), systolic and diastolic blood pressure, body weight, height, body mass index, waist circumference, total cholesterol, triglycerides, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), high sensitive C-reactive protein (hs-CRP), fibrinogen, UAE, creatinine, smoking status, exercise, alcohol consumption, use of hypoglycemic and lipid-lowering drugs, antihypertensive medications, and other data related to family history of diabetes and risk factors.
Ninety-five subjects (25.2%) developed a microvascular complication at the end of the follow-up period. In logistic regression analyses, the main independent risk factors were UAE >12mg/24h (odds ratio [OR]: 6.12; P=.000), hs-CRP> 3mg/L (OR: 3.00; P=.004), and hypertension (OR: 2.43; P=.023).
UAE levels higher than 12mg/24h, hs-CRP >3mg/L, and presence of hypertension were all independent risk factors for development of microvascular complications in patients with T2DM studied.
对无微血管并发症的2型糖尿病(T2DM)患者进行前瞻性研究,分析各种基线危险因素与随访时微血管并发症发生之间的关联。
对2004年纳入的376例T2DM患者进行前瞻性观察研究。临床终点为2007年随访时尿白蛋白排泄率(UAE)>30mg/24小时和/或存在视网膜病变。基线变量包括年龄、性别、T2DM病程、空腹血糖、糖化血红蛋白(HbA1c)、收缩压和舒张压、体重、身高、体重指数、腰围、总胆固醇、甘油三酯、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、高敏C反应蛋白(hs-CRP)、纤维蛋白原、UAE、肌酐、吸烟状况、运动、饮酒、使用降糖和降脂药物、抗高血压药物,以及其他与糖尿病家族史和危险因素相关的数据。
95名受试者(25.2%)在随访期结束时发生了微血管并发症。在逻辑回归分析中,主要的独立危险因素为UAE>12mg/24小时(比值比[OR]:6.12;P = .000)、hs-CRP>3mg/L(OR:3.00;P = .004)和高血压(OR:2.43;P = .023)。
在本研究的T2DM患者中,UAE水平高于12mg/24小时、hs-CRP>3mg/L和存在高血压均是微血管并发症发生的独立危险因素。