Department of Endocrinology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
Diabetes Research Institute of Fujian Province, Fuzhou, Fujian, China.
J Diabetes Investig. 2019 Sep;10(5):1307-1317. doi: 10.1111/jdi.13003. Epub 2019 Feb 5.
AIMS/INTRODUCTION: To investigate the relationship between different body mass index (BMI) levels and vascular complications in type 2 diabetes mellitus patients.
Data were collected from 3,224 individuals with type 2 diabetes mellitus (male/female: 1,635/1,589; age 61.31 ± 11.45 years), using a retrospective case study design. The association of BMI quintiles and diabetes mellitus vascular complications was assessed using multiple logistic regression models adjusting for age, sex, diabetes duration, smoking status, drinking and other confounders, using those with the lowest quintile of BMI as the reference group.
With increasing BMI, the detection rate of diabetic peripheral neuropathy and peripheral arterial disease initially decreased and then it increased, whereas the detection rate of diabetic kidney disease and carotid atherosclerotic plaques showed an upward trend; however, diabetic retinopathy was irregular. The odds ratios of diabetic peripheral neuropathy decreased as BMI increased from the 21st percentile to the 80th percentile initially, and increased when BMI was in >80th percentile. The same result was shown in peripheral arterial disease. BMI >80th percentile showed a 1.426-fold risk of diabetic kidney disease and a 1.336 -fold risk of carotid atherosclerotic plaque.
In patients with type 2 diabetes mellitus, the relationship between different BMIs and vascular complications varies. A U-shaped relationship was observed between BMI and diabetic peripheral neuropathy, as well as BMI and peripheral arterial disease. BMI is positively correlated with diabetic kidney disease and carotid atherosclerotic plaque; however, it is not correlated with diabetic retinopathy.
目的/引言:探讨不同体重指数(BMI)水平与 2 型糖尿病患者血管并发症的关系。
采用回顾性病例研究设计,收集 3224 例 2 型糖尿病患者(男/女:1635/1589;年龄 61.31±11.45 岁)的数据。使用多因素逻辑回归模型,在调整年龄、性别、糖尿病病程、吸烟状况、饮酒等混杂因素后,评估 BMI 五分位与糖尿病血管并发症的相关性,以 BMI 最低五分位组为参照组。
随着 BMI 的增加,糖尿病周围神经病变和外周动脉疾病的检出率最初下降,然后上升,而糖尿病肾病和颈动脉粥样硬化斑块的检出率呈上升趋势;然而,糖尿病视网膜病变呈不规则变化。随着 BMI 从第 21 百分位增加到第 80 百分位,糖尿病周围神经病变的比值比最初下降,当 BMI 超过第 80 百分位时又增加。在外周动脉疾病中也有同样的结果。BMI 超过第 80 百分位时,糖尿病肾病的风险增加 1.426 倍,颈动脉粥样硬化斑块的风险增加 1.336 倍。
在 2 型糖尿病患者中,不同 BMI 与血管并发症的关系不同。BMI 与糖尿病周围神经病变以及 BMI 与外周动脉疾病之间存在 U 型关系。BMI 与糖尿病肾病和颈动脉粥样硬化斑块呈正相关;然而,与糖尿病视网膜病变无关。