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高龄2型糖尿病患者发病年龄与糖尿病并发症发生率的比较

Comparison of Age of Onset and Frequency of Diabetic Complications in the Very Elderly Patients with Type 2 Diabetes.

作者信息

Lee Bong Ki, Kim Sang Wook, Choi Daehee, Cho Eun Hee

机构信息

Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea.

出版信息

Endocrinol Metab (Seoul). 2016 Sep;31(3):416-423. doi: 10.3803/EnM.2016.31.3.416. Epub 2016 Aug 26.

Abstract

BACKGROUND

The prevalence of type 2 diabetes in elderly people has increased dramatically in the last few decades. This study was designed to clarify the clinical characteristics of type 2 diabetes in patients aged ≥80 years according to age of onset.

METHODS

We reviewed the medical records of 289 patients aged ≥80 years with type 2 diabetes at the outpatient diabetes clinics of Kangwon National University Hospital from September 2010 to June 2014. We divided the patients into middle-age-onset diabetes (onset before 65 years of age) and elderly-onset diabetes (onset at 65+ years of age).

RESULTS

There were 141 male and 148 female patients. The patients had a mean age of 83.2±2.9 years and the mean duration of diabetes was 14.3±10.4 years. One hundred and ninety-nine patients had elderly-onset diabetes. The patients with elderly-onset diabetes had a significantly lower frequency of diabetic retinopathy and nephropathy, lower serum creatinine levels, lower glycated hemoglobin (HbA1c) levels, and similar coronary revascularization and cerebral infarction rates compared to those with middle-age-onset diabetes. There was no frequency difference in coronary revascularization and cerebral infarction and HbA1c levels between three subgroups (<5, 5 to 15, and ≥15 years) of diabetes duration in elderly onset diabetes. However, both in the elderly onset diabetes and middle-age-onset diabetes, the cumulative incidence of retinopathy was increasing rapidly according to the duration of diabetes.

CONCLUSION

We report that individuals with elderly-onset diabetes have a lower frequency of diabetic retinopathy and nephropathy and similar cardiovascular complications compared to those with middle-age-onset diabetes.

摘要

背景

在过去几十年中,老年人2型糖尿病的患病率急剧上升。本研究旨在根据发病年龄阐明80岁及以上2型糖尿病患者的临床特征。

方法

我们回顾了2010年9月至2014年6月在江原国立大学医院门诊糖尿病诊所就诊的289例80岁及以上2型糖尿病患者的病历。我们将患者分为中年发病糖尿病(65岁之前发病)和老年发病糖尿病(65岁及以后发病)。

结果

有141例男性和148例女性患者。患者的平均年龄为83.2±2.9岁,糖尿病平均病程为14.3±10.4年。199例患者为老年发病糖尿病。与中年发病糖尿病患者相比,老年发病糖尿病患者的糖尿病视网膜病变和肾病发生率显著更低,血清肌酐水平更低,糖化血红蛋白(HbA1c)水平更低,冠状动脉血运重建和脑梗死发生率相似。在老年发病糖尿病患者中,糖尿病病程的三个亚组(<5年、5至15年和≥15年)之间的冠状动脉血运重建、脑梗死和HbA1c水平没有频率差异。然而,在老年发病糖尿病和中年发病糖尿病中,视网膜病变的累积发生率均随糖尿病病程迅速增加。

结论

我们报告,与中年发病糖尿病患者相比,老年发病糖尿病患者的糖尿病视网膜病变和肾病发生率更低,心血管并发症相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97b2/5053054/4f743f6f0dcc/enm-31-416-g001.jpg

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