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胰岛素依赖型糖尿病:“欧洲糖尿病研究组胰岛素依赖型糖尿病并发症研究”——维也纳中心的研究结果

[Insulin-dependent diabetes mellitus:"EURODIAB IDDM Complications Study"--results from the Vienna center].

作者信息

Abrahamian H, Hörnlein B, Gurdet C, Willinger C, Zaruba E, Irsigler K

机构信息

3. Medizinische Abteilung, Krankenhauses der Stadt Wien-Lainz, Wien.

出版信息

Wien Klin Wochenschr. 1994;106(5):136-40.

PMID:8171869
Abstract

The EURODIAB IDDM complications study is a multicenter clinical study for evaluation of the prevalence of microvascular, macrovascular and acute metabolic complications in randomly selected samples of insulin-dependent diabetic patients attending 31 European diabetes centers. A total of 3250 patients were studied (mean age: 32.7 +/- 10 years, mean duration of diabetes: 14.7 +/- 9.3 years) by standardized, validated methods. The third medical department of the Vienna-Lainz hospital participated from Austria. 122 patients, age: 34.9 +/- 9.9 years, duration of diabetes: 16 +/- 10 years were recruited from this center. There was a wide variation in the frequency of complications between the different European centres: Prevalence of diabetic retinopathy 25-60%; Vienna showed the lowest prevalence (25%). Metabolic control (HbA1c) ranged from 5.7-9.4%; Vienna shared the second place with two other centers (6.0%). Despite the very low HbA1c in the Viennese population, the frequency of severe hypoglycemic attacks was in the lower range, which is an extraordinary result in this study. Incipient diabetic renal disease, characterized by microalbuminuria varied in frequency between 15 and 33% (Vienna 23%). Important associations of raised blood pressure (frequency in all centers: 8-41%, Vienna: 29%) with renal disease and retinopathy have implications for the initiation of preventive measures. The data on diabetic complications obtained from the EURODIAB study permit a comparison between the different European centers and emphasize the need for implementation of the St. Vincent recommendations.

摘要

欧洲糖尿病研究(EURODIAB IDDM)并发症研究是一项多中心临床研究,旨在评估从31个欧洲糖尿病中心随机选取的胰岛素依赖型糖尿病患者样本中微血管、大血管及急性代谢并发症的患病率。通过标准化的、经过验证的方法对总共3250名患者进行了研究(平均年龄:32.7±10岁,平均糖尿病病程:14.7±9.3年)。奥地利维也纳-莱茵茨医院的第三内科参与了此项研究。从该中心招募了122名患者,年龄为34.9±9.9岁,糖尿病病程为16±10年。不同欧洲中心之间并发症的发生率差异很大:糖尿病视网膜病变的患病率为25%-60%;维也纳的患病率最低(25%)。代谢控制水平(糖化血红蛋白)在5.7%-9.4%之间;维也纳与其他两个中心并列第二(6.0%)。尽管维也纳人群的糖化血红蛋白水平很低,但严重低血糖发作的频率处于较低范围,这在本研究中是一个非凡的结果。以微量白蛋白尿为特征的早期糖尿病肾病的发生率在15%至33%之间(维也纳为23%)。血压升高(所有中心的发生率:8%-41%,维也纳:29%)与肾病和视网膜病变之间的重要关联对预防措施的启动具有重要意义。从欧洲糖尿病研究中获得的糖尿病并发症数据有助于对不同欧洲中心进行比较,并强调实施圣文森特建议的必要性。

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