Tran Paul Minh Huy, Kim Eileen, Tran Lynn Kim Hoang, Khaled Bin Satter, Hopkins Diane, Gardiner Melissa, Bryant Jennifer, Bernard Risa, Morgan John, Bode Bruce, Reed John Chip, She Jin-Xiong, Purohit Sharad
Center for Biotechnology and Genomic Medicine, Augusta University, 1120, 15th Str., Augusta, GA 30912, USA.
Department of Neurology, Medical College of Georgia, Augusta University, 1120, 15th Str., Augusta, GA 30912, USA.
Int J Environ Res Public Health. 2021 Oct 21;18(21):11094. doi: 10.3390/ijerph182111094.
Development of complications in type 1 diabetes patients can be reduced by modifying risk factors. We used a cross-sectional cohort of 1646 patients diagnosed with type 1 diabetes (T1D) to develop a clinical risk score for diabetic peripheral neuropathy (DPN), autonomic neuropathy (AN), retinopathy (DR), and nephropathy (DN). Of these patients, 199 (12.1%) had DPN, 63 (3.8%) had AN, 244 (14.9%) had DR, and 88 (5.4%) had DN. We selected five variables to include in each of the four microvascular complications risk models: age, age of T1D diagnosis, duration of T1D, and average systolic blood pressure and HbA1C over the last three clinic visits. These variables were selected for their strong evidence of association with diabetic complications in the literature and because they are modifiable risk factors. We found the optimism-corrected R2 and Harrell's C statistic were 0.39 and 0.87 for DPN, 0.24 and 0.86 for AN, 0.49 and 0.91 for DR, and 0.22 and 0.83 for DN, respectively. This tool was built to help inform patients of their current risk of microvascular complications and to motivate patients to control their HbA1c and systolic blood pressure in order to reduce their risk of these complications.
通过改变风险因素，可以降低1型糖尿病患者并发症的发生率。我们使用了一个包含1646名确诊为1型糖尿病（T1D）患者的横断面队列，来制定糖尿病周围神经病变（DPN）、自主神经病变（AN）、视网膜病变（DR）和肾病（DN）的临床风险评分。在这些患者中，199名（12.1%）患有DPN，63名（3.8%）患有AN，244名（14.9%）患有DR，88名（5.4%）患有DN。我们在四个微血管并发症风险模型中各选择了五个变量：年龄、1型糖尿病诊断年龄、1型糖尿病病程、过去三次门诊就诊时的平均收缩压和糖化血红蛋白（HbA1C）。选择这些变量是因为它们在文献中有与糖尿病并发症相关的有力证据，并且它们是可改变的风险因素。我们发现，经乐观校正的R2和哈雷尔C统计量在DPN中分别为0.39和0.87，在AN中为0.24和0.86，在DR中为0.49和0.91，在DN中为0.22和0.83。该工具旨在帮助告知患者当前微血管并发症的风险，并激励患者控制糖化血红蛋白和收缩压，以降低这些并发症的风险。
