最佳血糖和血压目标而非血脂目标与降低糖尿病微血管并发症的患病率相关。

Optimal glycaemic and blood pressure but not lipid targets are related to a lower prevalence of diabetic microvascular complications.

机构信息

National Diabetes & Endocrine Centre, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.

National Diabetes & Endocrine Centre, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar; National Diabetes & Endocrine Centre, Al-Wakra Hospital, Hamad Medical Corporation, Doha, Qatar.

出版信息

Diabetes Metab Syndr. 2021 Sep-Oct;15(5):102241. doi: 10.1016/j.dsx.2021.102241. Epub 2021 Aug 8.

DOI:10.1016/j.dsx.2021.102241

PMID:34390975

Abstract

BACKGROUND

Diabetic microvascular complications are a major cause of morbidity and are related to glycaemic control and cardiovascular risk factors.

AIMS

We sought to determine the association of microvascular complications in relation to control of glycemia, blood pressure and lipids in T2DM patients attending secondary care in Qatar.

METHODS

This is a cross-sectional study undertaken in patients with T2DM attending Qatar's National Diabetes Centres. Patients underwent assessment of glycemia, blood pressure and lipids and prevalence of diabetic peripheral neuropathy (DPN), retinopathy and microalbuminuria.

RESULTS

We included 1114 subjects aged 52.1 ± 11.3 years with a duration of diabetes 10.0 ± 7.6 years and had a prevalence of 25.8% for DPN, 34.3% for painful DPN, 36.8% for microalbuminuria and 25.1% for retinopathy. Patients who achieved an HbA1c ≤ 7.0% compared to >7% had a significantly lower prevalence of DPN (P < 0.01), painful DPN (P < 0.01), retinopathy (P < 0.01) and microalbuminuria (P < 0.007). Patients who achieved a systolic BP ≤ 140 mmHg compared to >140 mmHg had a significantly lower prevalence of DPN (P < 0.001), painful DPN (P < 0.001), retinopathy (P < 0.001) and microalbuminuria (P < 0.001). Patients who achieved an LDL ≤2.6 mmol/l compared to >2.6 mmol/l had a significantly higher prevalence of DPN (P < 0.03), but no difference in other outcomes. There was no difference in microvascular complications between those who achieved a HDL-C ≥ 1.02 mmol/l, and among those who achieved triglycerides ≤1.7 mmol/l.

CONCLUSIONS

Optimal control of glycemia and blood pressure, but not lipids is associated with a lower prevalence of diabetic microvascular complications.

摘要

背景

糖尿病微血管并发症是发病率的主要原因，与血糖控制和心血管危险因素有关。

目的

我们旨在确定与卡塔尔二级保健机构就诊的 2 型糖尿病患者的血糖控制、血压和血脂相关的微血管并发症的关联。

方法

这是一项在卡塔尔国家糖尿病中心就诊的 2 型糖尿病患者中进行的横断面研究。患者接受了血糖、血压和血脂评估以及糖尿病周围神经病变（DPN）、视网膜病变和微量白蛋白尿的患病率评估。

结果

我们纳入了 1114 名年龄为 52.1±11.3 岁、糖尿病病程 10.0±7.6 年的患者，DPN 的患病率为 25.8%，有症状的 DPN 为 34.3%，微量白蛋白尿为 36.8%，视网膜病变为 25.1%。与 HbA1c>7.0%的患者相比，HbA1c≤7.0%的患者 DPN（P<0.01）、有症状的 DPN（P<0.01）、视网膜病变（P<0.01）和微量白蛋白尿（P<0.007）的患病率显著降低。与收缩压>140mmHg 的患者相比，收缩压≤140mmHg 的患者 DPN（P<0.001）、有症状的 DPN（P<0.001）、视网膜病变（P<0.001）和微量白蛋白尿（P<0.001）的患病率显著降低。与 LDL>2.6mmol/L 的患者相比，LDL≤2.6mmol/L 的患者 DPN（P<0.03）的患病率更高，但其他结局没有差异。在那些达到 HDL-C≥1.02mmol/L 的患者和那些达到甘油三酯≤1.7mmol/L 的患者之间，微血管并发症没有差异。