The natural history of diabetic-related complications in type 2 diabetes among middle-aged employees.

1. 本研究以日本西部电报电话株式会社的员工为研究对象，是一项自2000年开始进行的队列研究，目的是了解员工罹患2型糖尿病、高血压、代谢综合征等主要疾病的危险因素。此外，我们在大鸟健康促进中心开始了一项队列研究。2型糖尿病的诊断基线检查和随访时，如果空腹血糖水平为>26mg /dl (HbAlc >6.5%)，或者参与者正在服用口服降糖药或胰岛素，则诊断为2型糖尿病。数据收集和测量临床检查包括体格检查；人体测量;以及关于病史的自我调查问卷；空腹血糖水平的测定；以及生活方式特征，如定期体育锻炼的持续时间、吸烟情况和每日饮酒情况。蛋白尿的存在是由试纸试验进一步证实的。尿白蛋白和肌酐在晨斑样本中测定。眼底摄影评估视网膜病变。结果糖尿病组明显蛋白尿患病率为23.0%，非糖尿病组为7.3%。糖尿病组微量白蛋白尿患病率（23.3%）高于非糖尿病组（7.0%）。采用多元logistic回归模型对40岁及以上男性员工2型糖尿病患者随访4年的显性蛋白尿发生率进行评估。在调整了年龄、BMI、收缩压、舒张压、白细胞数量、HbAlc和高血压的存在后，与显性蛋白尿发生率增加相关。糖尿病视网膜病变占3.7%，眼底出血占13.9%。经年龄和性别调整后，空腹血糖和HbAlc升高增加了眼底出血的多重校正优势比。少

1. Setup of a cohort studyThis study of the employees working for Nippon Telegraph and Telephone West Corporation is an ongoing cohort investigation designed to clarify the risk factors for major diseases, including type 2 diabetes, hypertension, and metabolic syndrome etc since 2000. And furthermore, we started a cohort study at Ohtori Health Promotion Center.2. Diagnosis of type 2 diabetes mellitusType 2 diabetes at baseline examination and follow-up was diagnosed if the fasting plasma glucose level was >126 mg/dl, (HbAlc >6.5%), or if participants were taking oral hypoglycemic medication or insulin.3. Data collection and measurementsThe clinical examination consisted of a physical examination; anthropometric measurements; and self-administered questionnaires on a medical history; measurement of the fasting plasma glucose level; and life-style characteristics, such as the duration of regular physical exercise, smoking, and daily alcohol consumption. The presence of proteinuria was co … More nfirmed by a dipstick test. Urinary albumin and creatinine were measured in a morning spot sample. Retinopathy was assessed by fundus photography.4. ResultsThis study revealed a prevalence of overt proteinuria in 23.0% of diabetic group as compared with 7.3% of non-diabetic group. The prevalence of microalbuminuria was higher in diabetic group (23.3%) than in non-diabetic group (7.0%). Multiple logistic regression model was tested to assess the risk factor on incidence of overt proteinuria followed for 4 years in 40-year-old or more male employees with type 2 diabetes. After adjusting for age, BMI, systolic blood pressure, diastolic blood pressure, number of white blood cells, HbAlc, and the presence of hypertension was associated with an increased risk of incidence of overt proteinuria.Diabetic retinopathy was observed in 3.7% and hemorrhage of the eye ground in 13.9% of diabetic group. The increased fasting plasma glucose level and HbAlc were increased multiple-adjusted odds ratio of hemorrhage of the eye ground after adjustment for age and gender. Less