Sone Hirohito, Horikawa Chika, Tanaka-Mizuno Sachiko, Kawasaki Ryo, Fujihara Kazuya, Moriya Tatsumi, Araki Atsushi, Tanaka Shiro, Akanuma Yasuo
Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine, Niigata, Japan.
Department of Health and Nutrition, University of Niigata Prefecture Faculty of Human Life Studies, Niigata, Japan.
J Diabetes Investig. 2025 Mar;16(3):360-369. doi: 10.1111/jdi.14394. Epub 2024 Dec 24.
This review highlights the significance of the Japan Diabetes Complications Study (JDCS), one of the earliest large-scale studies of people with type 2 diabetes outside Europe and the United States, in understanding type 2 diabetes mellitus among East Asian populations, particularly in Japan. Historically, large-scale clinical studies on type 2 diabetes mellitus have predominantly focused on Western populations, despite East Asians comprising the largest proportion of diabetic patients globally. The JDCS, which was initiated in 1996, enrolled 2,033 Japanese type 2 diabetes mellitus patients. It aimed to evaluate the effects of intensive lifestyle interventions on diabetic complications. The study demonstrated that lifestyle-focused interventions significantly reduced the risk of stroke and other complications compared to conventional treatment. Key findings of its sub-analyses include the unique characteristics of Japanese patients with type 2 diabetes mellitus, such as their lower body mass index (BMI) compared to Western counterparts and a stronger association between even modest BMI increases and beta cell dysfunction. Additionally, the JDCS provided insights into the risk factors for nephropathy, retinopathy, and macrovascular complications, emphasizing the importance of controlling blood pressure, glycemia, and lifestyle factors. The study also explored the impact of diet, exercise, and mental health on diabetic outcomes, revealing the protective effects of physical activity and a balanced diet, while highlighting the risks associated with high salt intake and depression. A risk prediction model tailored to Japanese patients was also developed. Overall, this study made a significant contribution to the evidence-based management of type 2 diabetes mellitus in East Asia.
本综述强调了日本糖尿病并发症研究（JDCS）的重要性，该研究是欧美以外最早针对2型糖尿病患者开展的大规模研究之一，对于了解东亚人群，尤其是日本人群中的2型糖尿病具有重要意义。从历史上看，尽管东亚人在全球糖尿病患者中占比最大，但关于2型糖尿病的大规模临床研究主要集中在西方人群。JDCS于1996年启动，招募了2033名日本2型糖尿病患者。其目的是评估强化生活方式干预对糖尿病并发症的影响。该研究表明，与传统治疗相比，以生活方式为重点的干预措施显著降低了中风和其他并发症的风险。其亚分析的主要发现包括日本2型糖尿病患者的独特特征，例如与西方患者相比，他们的体重指数（BMI）较低，而且即使BMI适度增加与β细胞功能障碍之间的关联也更强。此外，JDCS还深入了解了肾病、视网膜病变和大血管并发症的危险因素，强调了控制血压、血糖和生活方式因素的重要性。该研究还探讨了饮食、运动和心理健康对糖尿病结局的影响，揭示了体育活动和均衡饮食的保护作用，同时突出了高盐摄入和抑郁症相关的风险。还开发了一个针对日本患者的风险预测模型。总体而言，这项研究为东亚2型糖尿病的循证管理做出了重大贡献。
