Davis T M, Stratton I M, Fox C J, Holman R R, Turner R C
Radcliffe Infirmary, Oxford, U.K.
Diabetes Care. 1997 Sep;20(9):1435-41. doi: 10.2337/diacare.20.9.1435.
To assess the effect of age at diagnosis on the initial prevalence and subsequent risk of the progression of diabetic tissue damage in patients with NIDDM.
The prevalence of Q-wave myocardial infarction, absent dorsalis pedis pulses, retinopathy, absent ankle jerks, hypertension, and microalbuminuria were determined at baseline and at 3 and 6 years of follow-up in five consecutive 6-year age-cohorts of 3,027 newly diagnosed white patients aged between 36 and 65 years recruited to the U.K. Prospective Diabetes Study. The effect of age at diagnosis on the initial prevalence and the risk of progression of these complications and associated conditions was analyzed using logistic regression and proportional odds methods, respectively.
Q-wave myocardial infarction and hypertension were more prevalent in older patients at presentation, but age at diagnosis did not have a significant effect on the increased risk of either after 6 years of NIDDM. Absent dorsalis pedis pulses and ankle jerks were also more prevalent in the older age-groups at presentation, but age at diagnosis was a significant predictor of the increasing prevalence of both during follow-up. The baseline prevalence of retinopathy and microalbuminuria was not related to age. The subsequent risk of retinopathy, but not microalbuminuria, increased significantly with age at diagnosis.
Age at diagnosis has a variable impact on different types of diabetic tissue damage and may thus be an important variable in epidemiological and intervention studies in NIDDM. Regular ophthalmologic surveillance and examination of the feet increase in importance with increasing age since the diagnosis of NIDDM.
评估非胰岛素依赖型糖尿病（NIDDM）患者诊断时的年龄对糖尿病组织损伤初始患病率及后续进展风险的影响。
在英国前瞻性糖尿病研究中，对连续五个6岁年龄组的3027例新诊断的36至65岁白人患者进行研究，于基线时以及随访3年和6年时测定Q波心肌梗死、足背动脉搏动消失、视网膜病变、踝反射消失、高血压和微量白蛋白尿的患病率。分别采用逻辑回归和比例优势方法分析诊断时的年龄对这些并发症及相关病症的初始患病率和进展风险的影响。
Q波心肌梗死和高血压在就诊时年龄较大的患者中更为普遍，但诊断时的年龄对NIDDM 6年后这两种病症风险的增加并无显著影响。足背动脉搏动消失和踝反射消失在就诊时年龄较大的人群中也更为普遍，但诊断时的年龄是随访期间这两种病症患病率增加的显著预测因素。视网膜病变和微量白蛋白尿的基线患病率与年龄无关。诊断时的年龄越大，视网膜病变的后续风险显著增加，但微量白蛋白尿的后续风险并非如此。
诊断时的年龄对不同类型的糖尿病组织损伤有不同影响，因此可能是NIDDM流行病学和干预研究中的一个重要变量。自诊断NIDDM以来，随着年龄增长，定期眼科检查和足部检查的重要性增加。
