Prolonged effect of intensive therapy on the risk of retinopathy complications in patients with type 1 diabetes mellitus: 10 years after the Diabetes Control and Complications Trial.
Prolonged effect of intensive therapy on the risk of retinopathy complications in patients with type 1 diabetes mellitus: 10 years after the Diabetes Control and Complications Trial.
复制标题
DOI：
10.1001/archopht.126.12.1707
复制
发表时间：
2008-12
影响因子：
--
通讯作者：
Nathan, David M.
中科院分区：
文献类型：
--
作者：
Nathan, David M.
在糖尿病干预和并发症流行病学（EDIC）的随访研究中，检查糖尿病控制和并发症试验（DCCT）后10年原有治疗效果的持续性。在DCCT中，与常规治疗相比，针对接近正常血糖的强化治疗降低了1型糖尿病微血管并发症的风险。在EDIC第10年，1211名受试者通过眼底摄影评估视网膜病变。DCCT结束后，早期治疗糖尿病视网膜病变研究量表的进一步3步进展是主要结局。经过10年的EDIC随访，原始治疗组的平均糖化血红蛋白水平（8.07% vs 7.98%）无显著差异。然而，与前常规治疗组相比，前强化治疗组的DCCT进一步视网膜病变进展和增生性视网膜病变或更严重的发生率显著降低（风险降低，53%-56%；P< 0.001）。与EDIC前4年的70% - 71%相比，EDIC治疗10年的风险（危害）降低（P< 0.001）。先前强化治疗的持续有益效果在很大程度上可以通过DCCT期间糖化血红蛋白水平的差异来解释。糖尿病视网膜病变在前强化治疗和常规治疗（“代谢记忆”）之间的持续差异至少持续10年，但可能正在减弱。
To examine the persistence of the original treatment effects 10 years after the Diabetes Control and Complications Trial (DCCT) in the follow-up Epidemiology of Diabetes Interventions and Complications (EDIC) study. In the DCCT, intensive therapy aimed at near-normal glycemia reduced the risk of microvascular complications of type 1 diabetes mellitus compared with conventional therapy. Retinopathy was evaluated by fundus photography in 1211 subjects at EDIC year 10. Further 3-step progression on the Early Treatment Diabetic Retinopathy Study scale from DCCT closeout was the primary outcome. After 10 years of EDIC follow-up, there was no significant difference in mean glycated hemoglobin levels (8.07% vs 7.98%) between the original treatment groups. Nevertheless, compared with the former conventional treatment group, the former intensive group had significantly lower incidences from DCCT close of further retinopathy progression and proliferative retinopathy or worse (hazard reductions, 53%-56%; P<.001). The risk (hazard) reductions at 10 years of EDIC were attenuated compared with the 70% to 71% over the first 4 years of EDIC (P<.001). The persistent beneficial effects of former intensive therapy were largely explained by the difference in glycated hemoglobin levels during DCCT. The persistent difference in diabetic retinopathy between former intensive and conventional therapy (“metabolic memory”) continues for at least 10 years but may be waning.
登录
查看更多内容
影响因子：
1.9
作者：
Lu, Bing;Preisser, John S.;Wolfson, Mark
通讯作者：
Wolfson, Mark
影响因子：
7.7
作者：
Monnier, VM;Bautista, O;Genuth, S
通讯作者：
Genuth, S
影响因子：
1.9
作者：
ODELL, PM;ANDERSON, KM;DAGOSTINO, RB
通讯作者：
DAGOSTINO, RB
影响因子：
9.3
作者：
Steffes, M;Cleary, P;Nowicki, M
通讯作者：
Nowicki, M
影响因子：
158.5
作者：
SHAMOON, H;DUFFY, H;SIEBERT, C
通讯作者：
SIEBERT, C