THE EFFECT OF PROTEINURIA ON RELATIVE MORTALITY IN TYPE-1 (INSULIN-DEPENDENT) DIABETES-MELLITUS
THE EFFECT OF PROTEINURIA ON RELATIVE MORTALITY IN TYPE-1 (INSULIN-DEPENDENT) DIABETES-MELLITUS
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DOI：
10.1007/bf00281993
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发表时间：
1985-01-01
期刊：
影响因子：
8.2
通讯作者：
DECKERT, T
中科院分区：
文献类型：
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作者：
BORCHJOHNSEN, K;ANDERSEN, PK;DECKERT, T
我们跟踪了1134名1型（胰岛素依赖型）糖尿病患者，这些患者在1933年至1952年间被确诊，直到1982年或死亡或移民。他们的糖尿病发病年龄在31岁以下。在每例病例中，均寻求有关持续性蛋白尿发生的信息。在104例病例中，数据有问题或无法追踪患者。29例患者出现非糖尿病性蛋白尿。在剩下的1,001例患者中，406例发生持续性蛋白尿（350例死亡），595例未发生（166例死亡）。持续性蛋白尿的发病率在男性中最高;从1933年到1952年，随着糖尿病发病年份的增加而降低，随着发病年龄的增加而降低。持续性蛋白尿患者的相对死亡率极高，在35岁时最高可达100例。未发生蛋白尿的患者的相对死亡率相对恒定较低，约为2。持续性蛋白尿的发生率降低，死亡率随着糖尿病发病时间的增加而降低，导致1950年诊断的患者的预期寿命比1935年诊断的患者增加了50%。在发生持续性蛋白尿的患者中，女性的相对死亡率在所有年龄段均高于男性。在未发生蛋白尿的患者中，35岁以后男性和女性的相对死亡率相似。尿毒症是持续性蛋白尿患者死亡的主要原因，尽管心血管死亡比无蛋白尿患者更常见。因此，蛋白尿不仅与尿毒症死亡有关，而且与心血管疾病死亡有关。结论：持续性蛋白尿的发生是早发1型糖尿病患者危及生命的主要并发症。不发生蛋白尿的患者几乎有正常的预期寿命。
We followed 1, 134 patients with Type 1 (insulin-dependent) diabetes, diagnosed between 1933 and 1952, until 1982 or death or until their emigration. Their age at onset of diabetes was under 31 years. Information concerning the development of persistent proteinuria was sought in every case. In 104 cases, the data were either questionable or the patient could not be traced. Twenty-nine patients developed non-diabetic proteinuria. Among the remaining 1,001 patients, 406 developed persistent proteinuria (350 died) and 595 did not (166 died). The incidence of persistent proteinuria was highest among men; it decreased with increasing year of diabetes onset from 1933 to 1952, and decreased with increasing age at onset. The relative mortality was extremely high among patients with persistent proteinuria, increasing to a maximum of about 100 at age 35 years. Patients not developing proteinuria had a relatively constant low relative mortality of about 2. The decreasing incidence of persistent proteinuria and the decreasing mortality with increasing calender year of diabetes onset resulted in a 50% increase in life-expectancy among patients diagnosed in 1950 compared with patients diagnosed in 1935. In patients who developed persistent proteinuria, relative mortality was higher in women in women than men at all ages. In patients who did not develop proteinuria, relative mortality was similar in men and women after the age of 35. Uraemia was the main cause of death in patients with persistent proteinuria, although cardiovascular deaths were more frequent than in patients without proteinuria. Thus, proteinuria is associated not only with death from uraemia but also from cardiovascular disease. It is concluded that the development of persistent proteinuria is a major life-threatening complication in patients with early-onset Type 1 diabetes. Patients who do not develop proteinuria have almost a normal life expectancy.