Nielsen N V, Ditzel J
Horm Metab Res Suppl. 1985;15:19-23.
The prevalence of macro- and microvascular disease and the distribution of glycosylated hemoglobin (Hb A1) were assessed in a representative Danish diabetes population living on the island of Falster with a population of 44.498 inhabitants. The diabetes population consisted of 533 diabetics of whom 166 were insulin-dependent (type I) and 367 non-insulin-dependent (type II). Among the 533 diabetics macrovascular complications as evidenced by myocardial infarction, gangrene or amputations and cerebrovascular catastrophes were present in 8%, 5% and 7%, respectively, while microvascular disease as evidenced by diabetic retinopathy was present in 53% of the cases. Multilogistic analysis showed no relationship between the macrovascular complications and the level of Hb A1, whereas there was a highly significant correlation between the level of Hb A1 and the presence of retinopathy in both patients with type I (P less than 0.01) and type II diabetes (P less than 0.001). The results emphasize the contention that the development of microvascular disease depends on the quality of blood glucose control while that of macrovascular disease seems unrelated to long-term hyperglycemia.
在法尔斯特岛一个有44498名居民的代表性丹麦糖尿病群体中，评估了大血管和微血管疾病的患病率以及糖化血红蛋白（Hb A1）的分布情况。该糖尿病群体由533名糖尿病患者组成，其中166名是胰岛素依赖型（I型），367名是非胰岛素依赖型（II型）。在这533名糖尿病患者中，心肌梗死、坏疽或截肢以及脑血管疾病所证实的大血管并发症分别占8%、5%和7%，而糖尿病视网膜病变所证实的微血管疾病在53%的病例中存在。多因素逻辑分析显示大血管并发症与Hb A1水平之间没有关系，而在I型（P小于0.01）和II型糖尿病患者（P小于0.001）中，Hb A1水平与视网膜病变的存在之间存在高度显著的相关性。结果强调了这样一种观点，即微血管疾病的发展取决于血糖控制的质量，而大血管疾病的发展似乎与长期高血糖无关。
