He Bin Bin, Xu Miao, Wei Li, Gu Yun Juan, Han Jun Feng, Liu Yu Xiang, Bao Yu Qian, Jia Wei Ping
Department of Endocrinology and Metabolism, Shanghai Clinical Center of Diabetes, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China. weili63@hotmail. com,
Department of Endocrinology and Metabolism, Shanghai Clinical Center of Diabetes, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China.
Arch Iran Med. 2015 May;18(5):277-83.
To evaluate the potential association of anemia with micro- and macrovascular complications in Chinese patient with type 2 diabetes mellitus (T2DM).
A total of 1997 patients with T2DM were included in this cross-sectional study. Patients were defined as anemic, if hemoglobin (Hb) levels were < 13 g/dL in males and < 12 g/dL in females. Data on demographics, anthropometric parameters, and co-morbidities were extracted for each patient.
Twenty two percent of T2DM patients (439/1997) had anemia, and those patients with higher rates of micro- and macrovascular complications had higher rates of anemia. Univariate logistic regression analysis showed that anemia was a risk factor of microvascular complications (OR = 1.83, 95% CI: 1.45 - 2.31; P < 0.001) and macrovascular complications (OR = 2.10, 95% CI: 1.63 - 2.71; P < 0.001). After adjusting for conventional risk factors, anemia remained positively associated with microvascular complications (OR = 1.52, 95% CI: 1.17 - 1.99), but lost its association with macrovascular complications (OR = 1.01, 95% CI: 0.73 - 1.41). Anemia was also independently associated with diabetic retinopathy, nephropathy, and peripheral neuropathy.
These findings suggest that anemia was related to both micro- and macrovascular complications in Chinese patients with T2DM, but was only an independent risk factor of microvascular complications. Assessment of Hb levels in T2DM patients may help to prevent subsequent diabetic micro- and macrovascular complications.
评估中国2型糖尿病(T2DM)患者贫血与微血管和大血管并发症之间的潜在关联。
本横断面研究共纳入1997例T2DM患者。男性血红蛋白(Hb)水平<13 g/dL且女性<12 g/dL的患者被定义为贫血。提取每位患者的人口统计学、人体测量参数和合并症数据。
22%的T2DM患者(439/1997)患有贫血,微血管和大血管并发症发生率较高的患者贫血发生率也较高。单因素逻辑回归分析显示,贫血是微血管并发症的危险因素(OR = 1.83,95%CI:1.45 - 2.31;P < 0.001)和大血管并发症的危险因素(OR = 2.10,95%CI:1.63 - 2.71;P < 0.001)。在调整传统危险因素后,贫血仍与微血管并发症呈正相关(OR = 1.52,95%CI:1.17 - 1.99),但与大血管并发症失去关联(OR = 1.01,95%CI:0.73 - 1.41)。贫血还与糖尿病视网膜病变、肾病和周围神经病变独立相关。
这些发现表明,贫血与中国T2DM患者的微血管和大血管并发症均相关,但仅是微血管并发症的独立危险因素。评估T2DM患者的Hb水平可能有助于预防随后的糖尿病微血管和大血管并发症。