Ito Hiroyuki, Omoto Takashi, Abe Mariko, Matsumoto Suzuko, Shinozaki Masahiro, Nishio Shinya, Antoku Shinichi, Mifune Mizuo, Togane Michiko
Department of Diabetes, Metabolism and Kidney Disease, Edogawa Hospital, Tokyo, Japan.
Geriatr Gerontol Int. 2017 Jan;17(1):24-30. doi: 10.1111/ggi.12654. Epub 2015 Dec 4.
The aim of the present study was to clarify the relationships between the duration of diabetes and the current statuses of diabetes in elderly (aged ≥65 years) patients with type 2 diabetes.
Clinical characteristics were cross-sectionally examined in 1436 patients (684 elderly and 752 non-elderly) with type 2 diabetes.
As the duration of diabetes increased, the patients' age, frequency of receiving insulin therapy and glycated hemoglobin value increased in both the elderly and non-elderly groups, whereas the urinary C-peptide immunoreactivity and glomerular filtration rate decreased. The duration of diabetes (years) was significantly associated with the prevalence of diabetic retinopathy (OR 1.05, 95% CI 1.03-1.07, P < 0.01), nephropathy (OR 1.03, 95% CI 1.01-1.05, P < 0.01) and neuropathy (OR 1.08, 95% CI 1.05-1.12, P < 0.01), but not with cerebrovascular disease (OR 1.01, 95% CI 0.99-1.03, P = 0.38), coronary heart disease (OR 1.02, 95% CI 1.00-1.04, P = 0.09) or peripheral artery disease (OR 1.02, 95%CI 0.99-1.05, P = 0.12) in the elderly patients after adjusting for the traditional risk factors of diabetic angiopathies. In contrast, the duration of diabetes showed a significant association with the prevalence of both diabetic micro- and macroangiopathies in the non-elderly patients.
It should be noted that atherosclerotic diseases are present in the clinical setting for the management of elderly diabetic patients independent of the duration of diabetes. Geriatr Gerontol Int 2017; 17: 24-30.
本研究旨在阐明老年（年龄≥65岁）2型糖尿病患者的糖尿病病程与当前糖尿病状态之间的关系。
对1436例2型糖尿病患者（684例老年患者和752例非老年患者）的临床特征进行横断面研究。
随着糖尿病病程的延长，老年组和非老年组患者的年龄、接受胰岛素治疗的频率和糖化血红蛋白值均升高，而尿C肽免疫反应性和肾小球滤过率降低。在校正糖尿病血管病变的传统危险因素后，老年患者的糖尿病病程（年）与糖尿病视网膜病变的患病率（比值比1.05，95%可信区间1.03 - 1.07，P < 0.01）、肾病（比值比1.03，95%可信区间1.01 - 1.05，P < 0.01）和神经病变（比值比1.08，95%可信区间1.05 - 1.12，P < 0.01）显著相关，但与脑血管疾病（比值比1.01，95%可信区间0.99 - 1.03，P = 0.38）、冠心病（比值比1.02，95%可信区间1.00 - 1.04，P = 0.09）或外周动脉疾病（比值比1.02，95%可信区间0.99 - 1.05，P = 0.12）无关。相比之下，糖尿病病程与非老年患者糖尿病微血管和大血管病变的患病率均显著相关。
应注意的是，在老年糖尿病患者的临床管理中，动脉粥样硬化疾病的存在与糖尿病病程无关。《老年医学与老年病学国际杂志》2017年；17：24 - 30。
