Arkkila P E, Kantola I M, Viikari J S, Rönnemaa T, Vähätalo M A
Department of Medicine, Turku University Central Hospital, Finland.
Clin Exp Rheumatol. 1996 Jan-Feb;14(1):59-65.
To clarify which are the underlying factors in the development of Dupuytren's disease (DD) in diabetic patients and to evaluate if the presence of DD can predict the development of diabetic complications.
A total of 207 type 1 diabetic patients [age (mean +/- SD): 29.9 +/- 9.5 years] was studied at baseline. A follow-up study was performed five years later in 166 patients. The presence of DD was examined and the patients were assessed in terms of the following diabetic complications: background and proliferative retinopathy, peripheral symmetrical polyneuropathy, and clinical nephropathy.
The prevalence of DD was 4% at the baseline study. DD was significantly associated with the age of the patient and the duration of diabetes, but not with the age at the onset of diabetes, BMI or the control of diabetes. DD was associated with somatic peripheral symmetrical polyneuropathy (p < 0.01), a history of myocardial infarction (p < 0.01) and limited joint mobility (LJM) (p < 0.05), but all of these associations could be exclusively explained by the age of the diabetic patients and the duration of diabetes. DD developed in 17 new subjects (2% per year) during the five years of the study. The subjects' age and the duration of diabetes were associated with the development of DD. There was a predominance of the development of DD in women (p < 0.05), and in subjects with retinopathy (p < 0.05), nephropathy (p < 0.05), neuropathy (p < 0.05) or hypertension (p < 0.01), but these associations could also be exclusively explained by the time-related variables. The presence of DD at the baseline study did not predict the development of diabetic complications or hypertension when the confounding effects of age and the duration of diabetes were controlled by logistic regression analysis.
This study shows that the patient's age and the duration of diabetes are the most important factors predicting the development of DD in diabetic patients. The associations between DD and diabetic complications were exclusively explained by the age and the duration of diabetes. The presence of DD did not predict the development of diabetic complications.
明确糖尿病患者发生掌腱膜挛缩症（DD）的潜在因素，并评估DD的存在是否可预测糖尿病并发症的发生。
共对207例1型糖尿病患者[年龄（均值±标准差）：29.9±9.5岁]进行了基线研究。5年后对166例患者进行了随访研究。检查是否存在DD，并根据以下糖尿病并发症对患者进行评估：背景性和增殖性视网膜病变、周围对称性多发性神经病变以及临床肾病。
在基线研究中，DD的患病率为4%。DD与患者年龄和糖尿病病程显著相关，但与糖尿病发病年龄、体重指数或糖尿病控制情况无关。DD与躯体周围对称性多发性神经病变（p<0.01）、心肌梗死病史（p<0.01）和关节活动受限（LJM）（p<0.05）相关，但所有这些关联都可完全由糖尿病患者的年龄和糖尿病病程来解释。在研究的5年中，有17名新患者（每年2%）发生了DD。受试者的年龄和糖尿病病程与DD的发生相关。女性（p<0.05）以及患有视网膜病变（p<0.05）、肾病（p<0.05）、神经病变（p<0.05）或高血压（p<0.01）的受试者中DD的发生更为常见，但这些关联也可完全由与时间相关的变量来解释。当通过逻辑回归分析控制年龄和糖尿病病程的混杂效应时，基线研究中DD的存在并不能预测糖尿病并发症或高血压的发生。
本研究表明，患者年龄和糖尿病病程是预测糖尿病患者发生DD的最重要因素。DD与糖尿病并发症之间的关联完全由年龄和糖尿病病程来解释。DD的存在并不能预测糖尿病并发症的发生。
