Zander E, Heinke P, Gottschling D, Zander G, Strese J, Herfurth S, Michaelis D
Clinic Karlsburg, Department of Diabetes and Metabolic Diseases, Germany.
Exp Clin Endocrinol Diabetes. 1997;105 Suppl 2:51-3. doi: 10.1055/s-0029-1211798.
Present cross-sectional clinical study was aimed at the evaluation the prevalence of cardiovascular risk factors in Type 2-diabetics suffering from different clinical manifestations of diabetic foot lesions due to peripheral vascular disease and/or diabetic neuropathy. 1025 non-insulin-dependent (Type 2) diabetics (NIDDM) of both sexes were investigated. Patients were classified in Type II diabetes without peripheral vascular disease and foot lesions (group 0, controls), with macroangiopathic related foot lesions (group 2), with neuropathic foot lesions (group 3), and with mixed neuropathic-ischemic foot lesions (group 4). Apart from urinary albumin excretion rate (UAE), the following micro- and macroangiopathic risk factors and diseases were taken into account: Hypertension, degree of metabolic control (HbA1c), lipid concentrations, duration of diabetes, retinopathy, clinical nephropathy.
In the total population the UAE was significantly (p < 0.01) correlated with duration of diabetes, serum creatinine, hypertension, age, lipid concentrations, HbA1c and insulin requirement. In comparison to Type II diabetic patients without peripheral vascular disease (group 0) and with neuropathic foot lesions (group 3), subjects with ischemic (group 2) and mixed neuropathic-ischemic foot lesions demonstrated an increased prevalence of pathological UAE, which was associated with a higher frequency of clinical nephropathy, retinopathy, an older age and longer duration of diabetes. It is concluded that microalbuminuria in Type 2 diabetes reflects both the existence of diabetic nephropathy and peripheral vascular disease which is often associated with the insulin resistance syndrome.
本横断面临床研究旨在评估2型糖尿病患者中因外周血管疾病和/或糖尿病神经病变导致糖尿病足病变不同临床表现的心血管危险因素的患病率。对1025例非胰岛素依赖型（2型）糖尿病患者（NIDDM）进行了调查，男女均有。患者被分为无外周血管疾病和足部病变的2型糖尿病组（0组，对照组）、与大血管病变相关的足部病变组（2组）、神经病变性足部病变组（3组）以及神经缺血性混合足部病变组（4组）。除尿白蛋白排泄率（UAE）外，还考虑了以下微血管和大血管病变危险因素及疾病：高血压、代谢控制程度（糖化血红蛋白A1c）、血脂浓度、糖尿病病程、视网膜病变、临床肾病。
在总体人群中，UAE与糖尿病病程、血清肌酐、高血压、年龄、血脂浓度、糖化血红蛋白A1c和胰岛素需求量显著相关（p < 0.01）。与无外周血管疾病的2型糖尿病患者（0组）和神经病变性足部病变患者（3组）相比，缺血性（2组）和神经缺血性混合足部病变患者的病理性UAE患病率增加，这与临床肾病、视网膜病变的较高发生率、年龄较大及糖尿病病程较长有关。结论是，2型糖尿病中的微量白蛋白尿既反映了糖尿病肾病的存在，也反映了常与胰岛素抵抗综合征相关的外周血管疾病。
