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新诊断的糖尿病前期的血管并发症及相关合并症:这只是冰山一角吗?

Vascular complications and associated comorbidities in newly diagnosed pre-diabetes: is it the tip of the iceberg?

机构信息

Department of Endocrinology and Metabolism, Inonu University School of Medicine, Malatya, Turkey.

出版信息

Eur Rev Med Pharmacol Sci. 2023 Aug;27(16):7557-7568. doi: 10.26355/eurrev_202308_33407.

Abstract

OBJECTIVE

The aim of this study was to investigate the prevalence of microvascular and macrovascular diabetic complications and the associated comorbidities in newly diagnosed pre-diabetic individuals.

PATIENTS AND METHODS

This cross-sectional study includes 100 newly diagnosed pre-diabetic individuals. Fasting plasma glucose, HbA1c, and oral glucose tolerance (OGTT) were tested according to the American Diabetes Association's diagnostic criteria for pre-diabetes, besides anthropometric measurements, lipid profiles, and demographic and biochemical parameters. Comorbidities like hypertension, obesity, dyslipidemia etc., were evaluated. All participants were screened for microvascular (retinopathy, nephropathy, neuropathy) and macrovascular [coronary artery disease (CAD) and cerebrovascular event-peripheral artery disease] complications.

RESULTS

Microvascular complications were found in 12% of the participants (neuropathy: 4%, nephropathy: 8%) and 19% had macrovascular complications. Of the participants, 21% of the cases presented hypertension, 21% dyslipidemia and 48% obesity. A high probability of developing non-alcoholic fatty liver disease-related fibrosis [estimated using non-alcoholic fatty liver disease fibrosis score (NFS)] was found in 68% of cases. History of dyslipidemia (OR: 5.00, 95% CI: 1.10-22.56; p=0.037) was an independent risk factor for the development of vascular complications.

CONCLUSIONS

Diabetic vascular complications were found in approximately one-third of pre-diabetic cases. Dyslipidaemia was found to be an important risk factor for the development of vascular complications in these individuals.

摘要

目的

本研究旨在调查新诊断的糖尿病前期个体中小血管和大血管糖尿病并发症的患病率以及相关合并症。

患者和方法

这是一项横断面研究,纳入了 100 名新诊断的糖尿病前期个体。根据美国糖尿病协会的糖尿病前期诊断标准,检测空腹血糖、HbA1c 和口服葡萄糖耐量(OGTT),同时进行人体测量、血脂谱以及人口统计学和生化参数的评估。评估了高血压、肥胖、血脂异常等合并症。所有参与者均筛查微血管(视网膜病变、肾病、神经病变)和大血管[冠心病(CAD)和脑血管事件-外周动脉疾病]并发症。

结果

12%的参与者存在微血管并发症(神经病变:4%,肾病:8%),19%存在大血管并发症。21%的参与者患有高血压,21%患有血脂异常,48%患有肥胖症。68%的患者存在非酒精性脂肪性肝病相关纤维化的高概率[使用非酒精性脂肪性肝病纤维化评分(NFS)估计]。血脂异常病史(OR:5.00,95%CI:1.10-22.56;p=0.037)是非血管并发症发展的独立危险因素。

结论

大约三分之一的糖尿病前期患者存在糖尿病血管并发症。血脂异常是这些患者发生血管并发症的重要危险因素。

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