Schumacher M C, Smith K R
Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City 84132.
Am J Public Health. 1988 Sep;78(9):1195-201. doi: 10.2105/ajph.78.9.1195.
From a telephone survey of the health status of a random sample of the general population of Utah, we identified 255 people with adult onset diabetes. We compared them to 622 non-diabetic controls, matched for age, sex, and urban/rural country of residence. We examined diabetes as a risk factor for heart diseases, stroke, and blindness and its interaction with other known risk factors. Diabetes interacted with smoking history so as to increase the risk of stroke, heart disease, and blindness. Diabetes also interacted with hypertension in their effect on the prevalence of blindness and, to a small extent, heart disease. Among the diabetics, duration of diabetes was associated with macrovascular and microvascular complications developing after the diagnosis of diabetes. Those with longer duration of disease showed an increase in risk for microvascular (kidney disease, blindness) and macrovascular (heart disease, stroke, amputations) complications. Although the estimates were imprecise, the effect of duration on macrovascular complications was greater among diabetics with a history of hypertension; the effect on microvascular complications was greater among smokers. The findings are compared to previous studies and the utility of diabetes prevalence data is discussed.
通过对犹他州普通人群随机样本进行的健康状况电话调查，我们确定了255名成年后发病的糖尿病患者。我们将他们与622名非糖尿病对照者进行比较，这些对照者在年龄、性别和城乡居住地上进行了匹配。我们研究了糖尿病作为心脏病、中风和失明的危险因素及其与其他已知危险因素的相互作用。糖尿病与吸烟史相互作用，从而增加了中风、心脏病和失明的风险。糖尿病在对失明患病率的影响方面也与高血压相互作用，在一定程度上也与心脏病相互作用。在糖尿病患者中，糖尿病病程与糖尿病诊断后发生的大血管和微血管并发症相关。病程较长者发生微血管（肾病、失明）和大血管（心脏病、中风、截肢）并发症的风险增加。尽管估计并不精确，但病程对有高血压病史的糖尿病患者大血管并发症的影响更大；对吸烟者微血管并发症的影响更大。将这些发现与之前的研究进行了比较，并讨论了糖尿病患病率数据的效用。
