Liu Wei, Wang Yanai, Han Xueyao, Cai Xiaoling, Zhu Yu, Zhang Mingxia, Gong Siqian, Li Juan, Ji Linong
Department of Endocrinology and Metabolism, Peking University People’s Hospital, Beijing, China.
Endocr Connect. 2020 Feb 13;9(2):187-193. doi: 10.1530/EC-19-0521.
Type 1 diabetes (T1DM) is associated with a higher risk of premature death, but there are factors in certain patients with T1DM that protect them from complications and premature death. These factors had not been identified in non-Caucasian populations, so we aimed to identify factors that protect against the development of diabetic nephropathy (DN) and diabetic retinopathy (DR) in long-standing T1DM in China
Ninety-five T1DM patients with >30 years’ duration of diabetes were enrolled in this nationwide study. Differences between groups of patients with and without complications were compared, and multivariable regression analysis was used to evaluate the relationships between candidate protective factors and the development of DN or DR.
Thirty of the participants did not have DN and the same amount did not have DR. 6/52 of participants without DN were from a rural area, whereas 11/28 of participants with DN had been born in a rural area (P = 0.005). Systolic blood pressure (SBP) was higher in participants with DN (135 ± 26 mmHg vs 121 ± 13 mmHg; P = 0.002). In participants without DR, 27/30 were married or cohabitating, and only 3/30 were single, never married, or widowed, but for those with proliferative DR (PDR), 13/26 had been married (P = 0.003). A rural or urban origin and SBP were associated with DN in the multivariable analysis.
we have shown that higher socioeconomic status, indicated by birth in an urban area, and being married or cohabitating, are accompanied by better blood pressure control and a lower risk of microvascular complications in Chinese patients with long-standing T1DM. These findings illustrate the importance of improving care for patients with T1DM in China.
1型糖尿病（T1DM）与过早死亡风险较高相关，但某些T1DM患者存在可使其免受并发症和过早死亡影响的因素。在非白种人群中尚未发现这些因素，因此我们旨在确定在中国长期患T1DM的患者中预防糖尿病肾病（DN）和糖尿病视网膜病变（DR）发生的因素。
95例糖尿病病程超过30年的T1DM患者参与了这项全国性研究。比较有并发症和无并发症患者组之间的差异，并采用多变量回归分析来评估候选保护因素与DN或DR发生之间的关系。
30名参与者没有DN，同样数量的参与者没有DR。无DN的参与者中有6/52来自农村地区，而有DN的参与者中有11/28出生在农村地区（P = 0.005）。有DN的参与者收缩压（SBP）较高（135±26 mmHg对121±13 mmHg；P = 0.002）。在没有DR的参与者中，27/30已婚或同居，只有3/30单身、未婚或丧偶，但对于患有增殖性DR（PDR）的患者，13/26已婚（P = 0.003）。多变量分析显示，城乡出身和SBP与DN相关。
我们已经表明，城市出生所表明的较高社会经济地位以及已婚或同居，伴随着中国长期患T1DM患者更好的血压控制和较低的微血管并发症风险。这些发现说明了改善中国T1DM患者护理的重要性。
