Yang Shanshan, Wang Shuang, Yang Bo, Zheng Jinliang, Cai Yuping, Yang Zhengguo
Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, State Key Laboratory of Kidney Disease, Chinese PLA General Hospital, Beijing Jinan Military Area CDC, Jinan, Shandong Department of Nephrology and Endocrinology, PLA 148th Hospital, Zibo, China.
Medicine (Baltimore). 2016 Dec;95(49):e5618. doi: 10.1097/MD.0000000000005618.
Our goal was to investigate the relationship between weight loss before a diagnosis of type 2 diabetes mellitus (T2DM) and diabetic complications among hospitalized patients with T2DM.We conducted a cross-sectional study and evaluated 347 and 642 hospitalized patients with T2DM who experienced and did not experienced weight loss before T2DM diagnosis, respectively. We used propensity score matching to reduce the confounding bias between the groups. In addition, a logistic regression analysis of the matched data was performed to evaluate the risk of diabetic complications.A total of 339 patients who experienced weight loss were matched to 339 patients who did not experience weight loss. After adjusting for age, gender, origin, occupation, smoking history, alcohol use, and duration of diabetes, the logistic regression analysis showed that compared with patients who did not experience weight loss, patients who lost ≤5 kg had a higher risk of diabetic nephropathy (DN) (odds ratio [OR]: 2.05, 95% confidence interval [CI]: 1.35-3.10) and diabetic retinopathy (OR: 1.79, 95% CI: 1.11-2.87). However, we did not observe a dose-response relationship in terms of weight loss.We found that weight loss before a diagnosis of T2DM might serve as a risk factor for DN and diabetic retinopathy. Our findings demonstrate that we should strengthen the management and prevention of complications in patients who experience weight loss of ≤5 kg prior to a T2DM diagnosis, particularly those who are centrally obese.
我们的目标是研究2型糖尿病（T2DM）诊断前体重减轻与住院T2DM患者糖尿病并发症之间的关系。我们进行了一项横断面研究，分别评估了347例和642例在T2DM诊断之前经历过和未经历过体重减轻的住院T2DM患者。我们使用倾向评分匹配来减少组间的混杂偏倚。此外，对匹配后的数据进行逻辑回归分析，以评估糖尿病并发症的风险。共有339例经历体重减轻的患者与339例未经历体重减轻的患者进行匹配。在对年龄、性别、籍贯、职业、吸烟史、饮酒情况和糖尿病病程进行校正后，逻辑回归分析显示，与未经历体重减轻的患者相比，体重减轻≤5千克的患者发生糖尿病肾病（DN）的风险更高（比值比[OR]：2.05，95%置信区间[CI]：1.35 - 3.10），发生糖尿病视网膜病变的风险也更高（OR：1.79，95%CI：1.11 - 2.87）。然而，我们未观察到体重减轻方面的剂量反应关系。我们发现，T2DM诊断前的体重减轻可能是DN和糖尿病视网膜病变的一个危险因素。我们的研究结果表明，对于在T2DM诊断前体重减轻≤5千克的患者，尤其是那些中心性肥胖的患者，我们应加强并发症的管理和预防。
