MICROVASCULAR AND ACUTE COMPLICATIONS IN IDDM PATIENTS - THE EURODIAB IDDM COMPLICATIONS STUDY
MICROVASCULAR AND ACUTE COMPLICATIONS IN IDDM PATIENTS - THE EURODIAB IDDM COMPLICATIONS STUDY
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DOI：
10.1007/bf00398055
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发表时间：
1994-03-01
期刊：
影响因子：
8.2
通讯作者：
FULLER, JH
中科院分区：
文献类型：
--
作者：
STEPHENSON, J;FULLER, JH
在一项针对欧洲 3250 名 IDDM 患者的横断面研究（EURODIAB IDDM 并发症研究）中，研究了微血管和急性糖尿病并发症的患病率及其与糖尿病持续时间和血糖控制的关系。糖尿病的平均 (SD) 病程为 14.7 (9.3) 年。 HbA(1c) 和 AER 是集中测量的。通过中央分级视网膜摄影评估视网膜病变。通过站立时的心率、心率和血压反应来测量自主神经病变。通过生物电测法测量感觉神经病。 16% 的患者 HbA(1c) 正常。所有患者中 30.6%（95% CI 29.0%、32.2%）的 AER 为 20 μg/min 或更高，1 至 5 年糖尿病患者中 AER 为 19.3%（15.6%、23.0%）。视网膜病变的患病率（所有患者为 46%；20 年后为 82%）显着低于可比研究中的患病率。在所有患者中，5.9 % (5.1 %, 6.7 %) 患有体位性低血压，19.3 % (17.9 %, 20.7 %) 患有心率变异性异常，32.2 % (30.6 %, 33.8 %) 报告在过去 12 个月内发生过一次或多次严重低血糖发作，8.6 % (7.6 %, 9.6 %) 报告同期因酮症入院。微血管和急性并发症与糖尿病病程和血糖控制明显相关。然而，血糖控制与蛋白尿升高的关系与其与视网膜病变的关系有本质上的不同。
The prevalence of microvascular and acute diabetic complications, and their relation to duration of diabetes and glycaemic control were examined in a cross-sectional study of 3250 IDDM patients in Europe (EURODIAB IDDM Complications Study). Mean (SD) duration of diabetes was 14.7 (9.3) years. HbA(1c) and AER were measured centrally. Retinopathy was assessed by centrally graded retinal photography. Autonomic neuropathy was measured by heart,rate and blood pressure responses to standing up. Sensory neuropathy was measured by biothesiometry. Normal HbA(1c) was found in 16 % of patients. An AER of 20 mu g/min or higher was found in 30.6 % (95 % CI 29.0 %, 32.2 %) of all patients, and 19.3 % (15.6 %, 23.0 %) of those with diabetes for 1 to 5 years. The prevalence of retinopathy (46 % in all patients; 82 % after 20 or more years) was substantially lower than in comparable studies. Of all patients 5.9 % (5.1 %, 6.7 %) had postural hypotension, 19.3 % (17.9 %, 20.7 %) had abnormal heart rate variability, 32.2 % (30.6 %, 33.8 %) reported one or more severe hypoglycaemic attacks during the last 12 months and 8.6 % (7.6 %, 9.6 %) reported hospital admission for ketosis over the same period. Microvascular and acute complications were clearly related to duration of diabetes and to glycaemic control. However, the relation of glycaemic control to raised albuminuria differed qualitatively from its relation to retinopathy.