Bognetti E, Calori G, Meschi F, Macellaro P, Bonfanti R, Chiumello G
Department of Paediatrics, Scientific Institute San Raffaele University of Milan, Italy.
J Pediatr Endocrinol Metab. 1997 Nov-Dec;10(6):587-92. doi: 10.1515/jpem.1997.10.6.587.
The prevalence and correlates of the early signs of renal, retinal and neurological microvascular complications were evaluated in 317 young patients with type I diabetes mellitus. Microalbuminuria was detected in 11% of patients and appeared to be strongly and positively related to HbA1c (p < 0.01) and less significantly to duration of diabetes (p < 0.02). Retinopathy was detected in 22.7% of patients and it was associated with duration of diabetes (p < 0.001). Peripheral neuropathy was detected in 18.5% of patients and there was a strong association with HbA1c (p < 0.01) and a weaker one with duration of diabetes (p < 0.05). Microalbuminuria was not detected in prepubertal patients while a similar frequency of retinopathy and neuropathy was observed in prepubertal and postpubertal patients. These results suggest that: 1) In short-term type I diabetic patients neuropathy is the most frequent microvascular complication, but after 10 years of diabetes, retinopathy exceeds the other complications; 2) Short-term metabolic control may influence the frequency of neuropathy and microalbuminuria but not retinopathy; 3) Puberty is involved in the appearance of microalbuminuria.
对317例1型糖尿病年轻患者的肾脏、视网膜和神经微血管并发症早期迹象的患病率及其相关因素进行了评估。11%的患者检测到微量白蛋白尿，其似乎与糖化血红蛋白（HbA1c）呈强正相关（p<0.01），与糖尿病病程的相关性较弱（p<0.02）。22.7%的患者检测到视网膜病变，其与糖尿病病程相关（p<0.001）。18.5%的患者检测到周围神经病变，其与HbA1c密切相关（p<0.01），与糖尿病病程的相关性较弱（p<0.05）。青春期前患者未检测到微量白蛋白尿，而青春期前和青春期后患者的视网膜病变和神经病变发生率相似。这些结果表明：1）在短期1型糖尿病患者中，神经病变是最常见的微血管并发症，但糖尿病10年后，视网膜病变超过其他并发症；2）短期代谢控制可能影响神经病变和微量白蛋白尿的发生率，但不影响视网膜病变；3）青春期与微量白蛋白尿的出现有关。
