Royal Melbourne Hospital Department of Diabetes and Endocrinology, Melbourne, Victoria, Australia.
Diabetes Res Clin Pract. 2012 Jul;97(1):57-62. doi: 10.1016/j.diabres.2012.02.012. Epub 2012 Mar 22.
Comprehensive data describing the effect of obesity on type 2 diabetes outcomes is lacking. We sought to address this by analyzing a tertiary hospital clinical database.
We extracted clinical and biochemical data for patients who attended a tertiary hospital diabetes clinic between 1998 and 2011 and were aged less than 65 years. Body mass index (BMI) was correlated with the prevalence of vascular complications and with cardiovascular risk factors.
The means of age and duration of diabetes for the 711 patients (392 men and 319 women) were 53 and 11 years respectively. BMI correlated with the prevalence of ischemic heart disease and, to a lesser degree, albuminuria, but not with the prevalence of cerebrovascular disease, neuropathy, retinopathy or renal function. BMI did not correlate with glycosylated hemoglobin, although obese patients used insulin both more frequently and at higher doses.
In people with long-standing type 2 diabetes who attend a tertiary hospital outpatient clinic, ischemic heart disease, in contrast to other vascular complications, correlates robustly with BMI. These findings indicate that clinical trials of weight loss in type 2 diabetes should use cardiac endpoints as their primary outcomes.
缺乏全面描述肥胖对 2 型糖尿病结局影响的数据。我们通过分析一家三级医院的临床数据库来解决这一问题。
我们提取了 1998 年至 2011 年间在一家三级医院糖尿病诊所就诊且年龄小于 65 岁的患者的临床和生化数据。体重指数(BMI)与血管并发症的患病率以及心血管危险因素相关。
711 例患者(392 名男性和 319 名女性)的平均年龄和糖尿病病程分别为 53 岁和 11 年。BMI 与缺血性心脏病的患病率相关,与蛋白尿的相关性稍差,但与脑血管疾病、神经病、视网膜病变或肾功能无关。BMI 与糖化血红蛋白无关,尽管肥胖患者更频繁且剂量更高地使用胰岛素。
在长期患有 2 型糖尿病并在三级医院门诊就诊的人群中,与其他血管并发症相比,缺血性心脏病与 BMI 密切相关。这些发现表明,2 型糖尿病减肥临床试验应将心脏终点作为主要终点。