A COMPARISON OF THE STUDY POPULATIONS IN THE DIABETES CONTROL AND COMPLICATIONS TRIAL AND THE WISCONSIN EPIDEMIOLOGIC-STUDY OF DIABETIC-RETINOPATHY
A COMPARISON OF THE STUDY POPULATIONS IN THE DIABETES CONTROL AND COMPLICATIONS TRIAL AND THE WISCONSIN EPIDEMIOLOGIC-STUDY OF DIABETIC-RETINOPATHY
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DOI：
10.1001/archinte.155.7.745
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发表时间：
1995-04-10
影响因子：
--
通讯作者：
MOSS, S
中科院分区：
文献类型：
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作者：
KLEIN, R;MOSS, S
背景资料：我们将糖尿病控制和并发症试验（DCCT）队列与威斯康星州糖尿病视网膜病变流行病学研究（WESDR）中的胰岛素依赖型糖尿病（IDDM）患者进行比较，以确定DCCT队列是否与普通人群中的IDDM患者相似，以及DCCT结果是否可推广到非研究人群。比较DCCT研究队列和WESDR队列中发病年龄小于30岁的IDDM患者的人口统计学和临床特征，随访时间为1980年至1986年。将DCCT合格性标准应用于WESDR队列，并确定符合DCCT一级预防和二级干预队列主要标准的患者。将DCCT一级预防和二级干预队列中常规治疗的受试者与其各自的WESDR组在临床特征、视网膜病变进展和总蛋白尿发生方面进行比较。基线时DCCT一级预防和二级干预队列与相应WESDR组的比较显示，诊断时年龄较大，DCCT队列中血红蛋白A（1c）（HbA（1c））水平较低，更频繁的注射和监测，但几乎没有其他实质性差异。对于常规治疗的DCCT和WESDR队列，视网膜病变的进展和与基线HbA（1c）水平的相关性相似，除了DCCT二次干预队列的进展率低于WESDR队列，这可能是因为较低的HbA（1c）水平。结论：基线时，DCCT队列中的患者与基于人群的WESDR队列中的IDDM患者基本相似，除了随着WESDR队列中HbA（1c）水平的降低，HbA（1c）水平的差异随时间而减小。DCCT和WESDR队列之间的人口统计学相似性、常规治疗患者的视网膜病变进展率相似以及DCCT和WESDR队列中HbA（1c）水平与视网膜病变进展之间的相关性相似，支持将DCCT结果推广至一般人群中的IDDM患者的有效性。
Background: We compared the Diabetes Control and Complications Trial (DCCT) cohort with patients who had insulin-dependent diabetes mellitus (IDDM) in the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR) to determine whether the DCCT cohort was similar to the patients with IDDM in the general population and whether the DCCT results are generalizable to a nonresearch population.Methods: Demographic and clinical characteristics were compared between the DCCT study cohort and the WESDR cohort of patients with IDDM with age at onset of diabetes at younger than 30 years and followed up from 1980 to 1986. The DCCT eligibility criteria were applied to the WESDR cohort, and patients were identified who fulfilled the major criteria of the DCCT primary prevention and secondary intervention cohorts. Conventionally treated subjects in the DCCT primary prevention and secondary intervention cohorts were compared with their respective WESDR groups with regard to clinical characteristics, progression of retinopathy, and development of gross proteinuria.Results: Comparison of the DCCT primary prevention and secondary intervention cohorts at baseline with the respective WESDR groups revealed an older age and an older age at diagnosis, a lower hemoglobin A(1c) (HbA(1c)) level, and more frequent injections and monitoring in the DCCT cohorts, but there were few other substantive differences. The progression of retinopathy and the association with baseline HbA(1c) level were similar for the conventionally treated DCCT and WESDR cohorts, except for a lower rate of progression in the DCCT secondary intervention cohort compared with that of the WESDR cohort, perhaps because of the lower HbA(1c) level.Conclusions: At baseline, patients in the DCCT cohort were generally similar to patients with IDDM in the population-based WESDR cohort, except for differences in the levels of HbA(1c) that diminished over time as the HbA(1c) levels in the WESDR cohort decreased. The demographic similarities between the DCCT and WESDR cohorts, the similar rates of progression of retinopathy in conventionally treated patients, and the similar associations between the HbA(1c) levels and progression of retinopathy in the DCCT and WESDR cohorts support the validity of generalizing the DCCT results to patients with IDDM in the general population.