Higher incidence of diabetic nephropathy in type 2 than in type 1 diabetes in early-onset diabetes in Japan.
Higher incidence of diabetic nephropathy in type 2 than in type 1 diabetes in early-onset diabetes in Japan.
复制标题
在日本早发性糖尿病中，2 型糖尿病肾病的发病率高于 1 型糖尿病。
作者：
H. Yokoyama;M. Okudaira;T. Otani;A. Sato;Junnoske Miura;Hiroko Takaike;Hitomi Yamada;Kazuko Muto;Y. Uchigata;Y. Ohashi;Y. Iwamoto
背景
糖尿病的类型、种族以及诊断的年份和年龄是否会影响糖尿病血管并发症的发生率尚不清楚。1型和2型糖尿病都发生在年轻的日本人群中，这促使我们调查糖尿病类型和诊断年份是否与肾病发病率有关。
方法
在1965至1990年间到我们糖尿病中心门诊就诊的17,256名糖尿病患者中，1578人(9.1%)患有早发性糖尿病(30岁前确诊)；其中620人(39%)为1型糖尿病，958人(61%)为2型糖尿病。根据青春期后病程和诊断年份分析患者中肾病的发生率。
结果
青春期后糖尿病30年后，2型糖尿病患者肾病累积发生率(44.4%，95%CI，37.0%~51.8%)显著高于1型糖尿病患者(20.2%，95%CI，14.9%~25.8%)(P<；0.0001)。在过去的二十年中，1型糖尿病患者的肾病发病率有所下降，而2型糖尿病患者的肾病发病率并没有下降。1980~1984年确诊的2型糖尿病患者与同期确诊的1型糖尿病患者的比率比为2.74(95%CI，1.17~6.41)。
结论
日本1型糖尿病患者的肾病发病率有所下降，但2型糖尿病患者的肾病发病率并未下降。在年轻的日本患者中，由于2型糖尿病肾病的发病率较高，而且2型糖尿病的患病率高于1型糖尿病，因此2型糖尿病可能是糖尿病肾病的主要原因。
BACKGROUND
Whether the type of diabetes, race, and year and age of diagnosis affect the incidence of diabetic vascular complications is unknown. That both type 1 and type 2 diabetes occur in the young Japanese population prompted us to investigate whether the type of diabetes and the year of diagnosis are related to the incidence of nephropathy.
METHODS
Of the 17,256 diabetic patients who visited the outpatient clinic at our diabetes center between 1965 and 1990, 1578 (9.1%) had early-onset diabetes (diagnosed before the age of 30); of these, 620 (39%) had type 1, and 958 (61%) had type 2 diabetes. The incidence of nephropathy was analyzed in the patients according to postpubertal duration and year of diagnosis.
RESULTS
The cumulative incidence of nephropathy after 30 years of postpubertal diabetes was significantly higher (P < 0.0001) in type 2 diabetic patients (44.4%, 95% CI, 37.0 to 51.8%) than in type 1 diabetic patients (20.2%, 95% CI, 14.9 to 25.8%). The incidence of nephropathy among type 1 diabetic patients has declined during the past two decades, whereas it has not among type 2 diabetic patients. The rate ratio for type 2 diabetic patients diagnosed between 1980 and 1984 relative to type 1 diabetic patients diagnosed in the same period was 2.74 (95% CI, 1. 17 to 6.41).
CONCLUSIONS
The incidence of nephropathy has declined in Japanese patients with type 1 but not in those with type 2 diabetes. In young Japanese patients, because of the higher incidence of nephropathy in type 2 diabetes and the higher prevalence of type 2 than type 1 diabetes, type 2 diabetes is likely the major cause of diabetic nephropathy.
高血压和糖尿病对黑人 NIDDM 受试者肾功能的相互作用。
影响因子：
19.6
作者：
Chaiken,RL;Palmisano,J;Norton,ME;Banerji,MA;Bard,M;Sachimechi,I;Behzadi,H;Lebovitz,HE
通讯作者：
Lebovitz,HE