Orthostatic hypotension in diabetic patients-10-year follow-up study
Orthostatic hypotension in diabetic patients-10-year follow-up study
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DOI：
10.1016/j.jdiacomp.2015.08.020
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发表时间：
2016-01-01
影响因子：
3
通讯作者：
Dukat, Andrej
中科院分区：
文献类型：
--
作者：
Gaspar, Ludovit;Kruzliak, Peter;Dukat, Andrej
糖尿病患者的心血管自主神经病变是一种常见的糖尿病并发症，但常被低估和漏诊。直立性低血压是心血管自主神经病变最明显的临床表现之一。目的：回顾性评价直立性低血压（OH）与糖尿病大血管和微血管并发症的关系，并确定其对死亡率的影响。设计与方法：回顾性分析187例糖尿病患者，其中60例为1型糖尿病，127例为2型糖尿病。根据是否存在OH和糖尿病类型将患者分为两组。评估OH与大血管和微血管并发症的关系，并评估OH对10年全因死亡率的影响。结果：1型糖尿病（DM1）患者中有31.7%存在OH， 2型糖尿病（DM2）患者中有32.3%存在OH。OH与DM1区心肌梗死患病率呈正相关（OR = 10.67），与DM2区卒中患病率呈正相关（OR = 3.33）。在DM1 （OR = 14.18）和DM2 （OR = 3.26）中，OH与外周动脉疾病的患病率也有很强的相关性。糖尿病合并OH患者肾病（DM1 OR = 8.68, DM2 OR = 324）、视网膜病变（DM1 OR = 8.09, DM2 OR = 4.08）和周围神经病变（DM1 OR = 17.14, DM2 OR = 7.51）的患病率均显著高于糖尿病合并OH患者。结论：OH在糖尿病患者中的存在与糖尿病大血管和微血管并发症的高发率以及10年死亡率相关。(C) 2016 Elsevier Inc.版权所有。
Introduction: Cardiovascular autonomic neuropathy in diabetics is a common but often underestimated and underdiagnosed complication of diabetes mellitus. One of the most clinical apparent forms of cardiovascular autonomic neuropathy is orthostatic hypotension.Objectives: To retrospectively assess the association of the orthostatic hypotension (OH) with macrovascular and microvascular complications of diabetes mellitus and to determine its effect on mortality.Design and methods: We retrospectively analyzed 187 patients with diabetes mellitus (60 patients with diabetes type 1 and 127 patients with diabetes type 2). Patients were divided into groups according to presence or absence of OH and type of diabetes. Association of OH with macrovascular and microvascular complications was evaluated and the effect of OH on 10-year all-cause mortality was also assessed.Results: OH was present in 31.7% of patients with diabetes type 1 (DM1) and in 32.3% of patients with diabetes type 2 (DM2). OH was positively associated with the prevalence of myocardial infarction in DM1 (OR = 10.67) and with prevalence of stroke in DM2 (OR = 3.33). There was also a strong association of OH and the prevalence of peripheral artery disease in both DM1 (OR = 14.18) and DM2 (OR = 3.26). Patients with both types of diabetes and OH had significantly higher prevalence of nephropathy (DM1 OR = 8.68, DM2 OR = 324), retinopathy (DM1 OR = 8.09, DM2 OR = 4.08) and peripheral neuropathy (DM1 OR = 17.14, DM2 OR = 7.51) Overall 10 year mortality rate was higher in diabetic patients with OH.Conclusions: Presence of OH in diabetics is associated with higher prevalence of macrovascular and microvascular complications of diabetes mellitus and also with higher 10-year mortality. (C) 2016 Elsevier Inc. All rights reserved.