Department of Endocrinology and Metabolism, Xijing Hospital, Xi'an, Shaanxi, China.
Department of Cardiology, Peking University People's Hospital, Beijing, China.
J Diabetes Investig. 2020 Sep;11(5):1285-1294. doi: 10.1111/jdi.13262. Epub 2020 May 4.
AIMS/INTRODUCTION: There are substantial differences in genes, diet, culture and environment between the northern and southern Chinese populations, which might influence treatment strategy and screening policy. We studied the differences in type 2 diabetes and diabetic complications between northern and southern China.
We carried out a cross-sectional survey using data from the China Cardiometabolic Registries on blood pressure, blood lipids and blood glucose in 25,398 Chinese type 2 diabetes patients. Macrovascular, microvascular and other complications were collected by self-report or medical records, and then divided into the northern and southern groups by the boundary of the Yangtze River.
Northern patients were younger, and had heavier weight, greater body mass index and waist circumference, higher blood pressure, higher total cholesterol, higher low-density lipoprotein cholesterol, and higher hemoglobin A1C. The prevalence of cardiovascular, cerebrovascular and macrovascular complications were 1.76-fold, 1.24-fold and 1.47-fold more in northern than that in southern Chinese patients. In addition, the prevalence of diabetic nephropathy, retinopathy, neuropathy and microvascular complications in northern Chinese patients also increased. When stratified by age, the difference in both cardiovascular disease and ischemic stroke morbidity became significant, even in the 35-44 years age group.
More macrovascular and microvascular complications were found in northern compared with southern patients, and the largest difference also appeared in the younger age groups <55 years, which might be meaningful to a screening and treatment strategy according to geographic differences.
目的/引言:中国南北人群在基因、饮食、文化和环境方面存在很大差异,这可能会影响治疗策略和筛查政策。我们研究了中国南北人群 2 型糖尿病及其并发症的差异。
我们使用中国心血管代谢注册研究的血压、血脂和血糖数据,对 25398 例中国 2 型糖尿病患者进行了横断面调查。通过自我报告或病历收集大血管、微血管和其他并发症,并按长江边界将其分为南北两组。
北方患者较年轻,体重、体重指数和腰围较大,血压、总胆固醇、低密度脂蛋白胆固醇和糖化血红蛋白较高。与南方患者相比,北方患者心血管、脑血管和大血管并发症的患病率分别高出 1.76 倍、1.24 倍和 1.47 倍。此外,北方患者糖尿病肾病、视网膜病变、神经病变和微血管并发症的患病率也有所增加。按年龄分层,心血管疾病和缺血性卒中发病率的差异变得显著,甚至在 35-44 岁年龄组也是如此。
与南方患者相比,北方患者有更多的大血管和微血管并发症,而且在<55 岁的年轻人群中差异最大,这可能对根据地域差异制定筛查和治疗策略具有重要意义。