Maximum body mass index before onset of type 2 diabetes is independently associated with advanced diabetic complications.
Maximum body mass index before onset of type 2 diabetes is independently associated with advanced diabetic complications.
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DOI：
10.1136/bmjdrc-2021-002466
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发表时间：
2021-12
影响因子：
4.1
通讯作者：
Shimomura I
中科院分区：
文献类型：
--
作者：
Ozawa H;Fukui K;Komukai S;Y Baden M;Fujita S;Fujita Y;Kimura T;Tokunaga A;Iwahashi H;Kozawa J;Shimomura I
2型糖尿病(MBBO)患者发病前的最大体重指数(BMI)可用来评估患者的胰岛素分泌能力。在诊断糖尿病时，几乎没有什么因素可以预测未来的糖尿病并发症。本研究旨在阐明MBBO在预测晚期糖尿病微血管并发症发展中的临床应用价值。这是一项横断面观察性研究。在连续入院的1304名2型糖尿病患者中，我们招募了435名可以确认其MBBO的患者。对入院时MBBO或BMI是否与晚期糖尿病视网膜病变或肾病相关进行了单因素和多因素Logistic回归分析。为了评估这些指标的预测性能，我们用MBBO或BMI在不同的模型中进行了交叉验证，并评估了这些分析产生的曲线下面积(AUC)。单变量分析表明，MBBO与晚期视网膜病变和肾病相关，而入院时的BMI仅与晚期肾病相关。在多变量分析中，MBBO与晚期并发症显著相关，而入院时的BMI则不显著。晚期糖尿病视网膜病变的AUC为0.70~0.72，晚期肾病的AUC为0.81~0.83。当比较模型间的AUC时，含MBBO的模型对糖尿病并发症的预测能力较高。MBBO与晚期糖尿病并发症独立相关，而入院时BMI与糖尿病并发症无关。高MBBO患者的糖尿病微血管并发症进展更快。在诊断糖尿病时，MBBO将使我们能够预测糖尿病并发症的进展。
The maximum body mass index (BMI) before onset of type 2 diabetes (MBBO) might be used to estimate a patient’s insulin secretion capacity. There have been few factors that can predict future diabetic complications at the time of diagnosis of diabetes mellitus. This study aimed to clarify the clinical usefulness of MBBO for predicting the development of advanced diabetic microvascular complications. This was a cross-sectional observational study. Of 1304 consecutively admitted patients with type 2 diabetes, we enrolled 435 patients for whom we could confirm their MBBO. Univariate and multivariate logistic regression analyses were performed to examine whether MBBO or BMI on admission was associated with advanced diabetic retinopathy or nephropathy. To evaluate the predictive performance of these indexes, we performed cross-validation in various models with MBBO or BMI and evaluated the areas under the curve (AUCs) yielded by these analyses. Univariate analyses suggested that MBBO was associated with advanced retinopathy and nephropathy, while BMI on admission was associated only with advanced nephropathy. In multivariate analyses, MBBO was significantly associated with advanced complications, while BMI on admission was not. For advanced diabetic retinopathy, the AUCs were 0.70–0.72, and for advanced nephropathy, the AUCs were 0.81–0.83. When comparing the AUCs among models, the models with MBBO sustained high predictive performance for diabetic complications. MBBO was independently associated with advanced diabetic complications, while BMI on admission was not. Diabetic microvascular complications in patients with high MBBO could progress more rapidly. At the time of the diagnosis of diabetes mellitus, MBBO would enable us to predict the progress of diabetic complications.
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影响因子：
2.9
作者：
Cui J;Ren JP;Chen DN;Xin Z;Yuan MX;Xu J;You QS;Yang JK
通讯作者：
Yang JK
影响因子：
19.6
作者：
通讯作者：
--
影响因子：
2
作者：
Fujita, Yukari;Kozawa, Junji;Shimomura, Iichiro
通讯作者：
Shimomura, Iichiro
影响因子：
168.9
作者：
Dormandy, JA;Charbonnel, B;Taton, J
通讯作者：
Taton, J
影响因子：
4.1
作者：
Ozawa, Harutoshi;Fukui, Kenji;Shimomura, Iichiro
通讯作者：
Shimomura, Iichiro