肥胖与微血管并发症与 2 型糖尿病患者血糖控制的关系。
The Association of Obesity and Microvascular Complications with Glycemic Control in Patients with Type 2 Diabetes Mellitus.
机构信息
Primary Health Care Center, Banja Luka, Bosnia and Herzegovina.
Clinic for Cutaneous and Sexually Transmitted Diseases, University Clinical Center of Republic of Srpska, Bosnia and Herzegovina.
出版信息
Med Arch. 2020 Feb;74(1):14-18. doi: 10.5455/medarh.2020.74.14-18.
INTRODUCTION
According Type 2 diabetes mellitus is a chronic metabolic disease with a high prevalence characterized by elevated blood glycemic values and with progressive development of micro and macrovascular complications. Glycemia control is a very important factor in the process of "delaying" the onset of complications by glycated hemoglobin (HbA1c) analysis.
AIM
The aim of the study is to determine the association of obesity, microvascular complications with glycemic control in patients with type 2 diabetes.
METHODS
The study was prospective, involving 105 patients with type 2 diabetes. It was conducted at the University Clinical Center of the Republic of Srpska from January 2016 to January 2018. The patients were adults, of both sexes, suffering from type 2 diabetes, in whom complications of this disease are present. Glycemic control was evaluated based on a target HbA1c value of 7%.
RESULTS
Out of the 105 patients in the study, 45.8% were male, 54.2% female. The mean age of the patients was 68.3%±10.7 years. The mean HbA1c level was 8.32±1.57%. Of the total number of patients, in 25.7% the HbA1c levels were ≤7.0%, while in 74.3% the HbA1c were ≥7.0% (p<0.001). There were 57.1% of obese patients, of whom 37.0% had HbA1c ≤7.0%, and 64.1% had HbA1c ≥7.0% (p<0.014). Depending on the duration of diabetes, the study found that ≥7.0% HbA1c was more present in patients with an diabetes duration over 20 years (24.4%) compared with those who had had the diabetes for less than 20 years (3.8%) (p<0.037). Microvascular complications were present in 58 patients (55.2%), of which 33.3% had normal HbA1c values, while unregulated glycemia had 62.8% (p<0.008). Retinopathy was present in 40.9%, polyneuropathy 37.1% and nephropathy 32.4% from which the unregulated glycemia (HbA1c ≥7.0%) was present in 39.7% of patients compared to normal glycemic values in 11.1 % of respondents (p<0.006). In 88 patients, certain diseases were present: hypertension in 76.2% of patients, cardiovascular disease 58.0% and hyperlipidemia 35.2%.
CONCLUSION
Glycemia control in obese patients with type 2 diabetes mellitus is important especially for the prevention of serious microvascular complications that significantly affect the quality of life of patients.
简介
2 型糖尿病是一种常见的代谢性疾病，其特征是血糖升高，随着时间的推移会逐渐出现微血管和大血管并发症。糖化血红蛋白（HbA1c）分析是控制血糖的重要手段，可以延缓并发症的发生。
目的
本研究旨在探讨肥胖和微血管并发症与 2 型糖尿病患者血糖控制之间的关系。
方法
这是一项前瞻性研究，共纳入 105 例 2 型糖尿病患者。研究于 2016 年 1 月至 2018 年 1 月在塞尔维亚共和国临床中心进行。所有患者均为成年男女，患有 2 型糖尿病且存在该疾病的并发症。通过目标 HbA1c 值 7%评估血糖控制情况。
结果
研究中，45.8%的患者为男性，54.2%为女性。患者的平均年龄为 68.3%±10.7 岁。平均 HbA1c 水平为 8.32%±1.57%。在总患者中，有 25.7%的 HbA1c 水平≤7.0%，而 74.3%的 HbA1c 水平≥7.0%（p<0.001）。有 57.1%的患者肥胖，其中 37.0%的 HbA1c 水平≤7.0%，64.1%的 HbA1c 水平≥7.0%（p<0.014）。根据糖尿病病程，发现病程超过 20 年的患者中 HbA1c≥7.0%的比例（24.4%）高于病程小于 20 年的患者（3.8%）（p<0.037）。有 58 例（55.2%）患者存在微血管并发症，其中 33.3%的患者 HbA1c 值正常，而未控制的血糖则占 62.8%（p<0.008）。视网膜病变占 40.9%，多发性神经病占 37.1%，肾病占 32.4%，其中 39.7%的患者血糖控制不佳（HbA1c≥7.0%），而血糖控制正常的患者占 11.1%（p<0.006）。在 88 例患者中存在其他疾病：高血压占 76.2%，心血管疾病占 58.0%，高脂血症占 35.2%。
结论
肥胖的 2 型糖尿病患者控制血糖非常重要，特别是可以预防严重的微血管并发症，这会显著影响患者的生活质量。
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