CARDIOVASCULAR DISEASE IN TYPE I DIABETES

这项建议描述了一个以人口为基础的队列，旨在确定 心血管疾病患病率和死亡率 在长期患有1型糖尿病的人中。对于这一流行病 研究对象包括所有服用胰岛素的人，他们：(1)低于 确诊时年满30岁，(2)已接受初诊 威斯康星州中南部11个县地区的医疗保健，以及(3) 在1979-80年首次被发现。考试和考试的标准化方案 访谈是在基线、4年、10年和14年期间进行的 跟进检查。拒绝率一直很低。中国人的平均年龄 队列和长期的糖尿病提供了一个机会 记录冠心病的患病率和发病率， 心肌梗塞、心绞痛、充血性心力衰竭、中风、一过性 缺血性发作、外周血管疾病和心血管疾病 以人群为基础的一大批1型患者的死亡率 糖尿病。每个研究参与者的视网膜照片都是在 基线检查。这将允许我们测试预测能力 局限性和全身性视网膜小动脉狭窄与动静脉的关系 后续大血管事件的交叉变化(即A/V划痕) 控制其他风险因素。这些因素包括血压， 吸烟、血脂、体重指数、糖尿病病程、 和血糖。我们计划重新检查这个队列，以获得心电图，血脂 以前没有测量过的组分，纤维蛋白原，以及上部和 四肢血压、尿样和医疗记录。 这将提供有关静默脑梗塞的信息，以及 其他心电图异常以及先前医生诊断的 1型糖尿病长期存活者的大血管事件。学习 检查将在一辆流动面包车上进行。参与者将提供 两份尿液标本测定尿白蛋白排泄量。 空腹采血测定糖化程度 血红蛋白、血糖、血清胆固醇、甘油三酯、高密度脂蛋白- 胆固醇，低密度脂蛋白-胆固醇，低密度脂蛋白-胆固醇，低密度脂蛋白颗粒大小，血清 肌酸和纤维蛋白原。其他研究程序包括 测量体重和身高、腰围和臀围以及臂围和腰围 脚踝血压。还将进行心电图检查。一个 将对调查问卷进行管理，参与者随后将 年度访谈、临床和住院记录以及死亡 将收集证书以记录新的心血管疾病 事件。关于心血管疾病患病率和发病率的研究结果 疾病和相关的风险因素将对公众健康产生重大影响。 进一步指导预防人类出现这种情况的重要性 病程长的1型糖尿病。

This proposal describes a population-based cohort aimed at determining the prevalence and incidence of cardiovascular disease morbidity and mortality in people with Type 1 diabetes of long-duration. For this epidemiologic study, subjects include all insulin-taking persons who: (1) were less than 30 years of age at the time of their diagnosis, (2) had received primary medical care in an 11-county area of south-central Wisconsin, and (3) were first identified in 1979-80. Standardized protocols for examinations and interviews have been employed during the baseline, 4-, 10-, and 14-year follow up examinations. Refusal rates have been low. The mean age of the cohort and the long duration of diabetes provide an opportunity to document the prevalence and incidence of coronary heart disease, myocardial infarction, angina, congestive heart failure, stroke, transient ischemic attacks, peripheral vascular disease, and cardiovascular disease mortality in a large population-based group of persons with Type 1 diabetes. Retinal photographs of each study participant were taken at the baseline examination. This will permit us to test the predictive ability of focal and generalized retinal arteriolar narrowing and arterio-venous cross changes (i.e. A/V nicking) for subsequent macrovascular events controlling for other risk factors. These factors include blood pressure, cigarette smoking, serum lipids, body mass index, duration of diabetes, and glycemia. We plan to reexamine this cohort to obtain ECGs, blood lipid fractions not previously measured, and fibrinogen, as well as upper and lower extremity blood pressures, urine specimens, and medical records. This will provide information about silent about silent infarctions and other cardiographic abnormalities as well as previously doctor-diagnosed macrovascular events in long-term survivors of Type 1 diabetes. Study examinations will be performed in a mobile van. Participants will provide two urine specimens for determination of urinary albumin excretion. Fasting blood will be obtained for determination of glycosylated hemoglobin Alc, blood sugar, serum cholesterol, triglycerides, HDL- cholesterol, LDL-cholesterol, VDL-cholesterol, LDL particle size, serum creatinine, and fibrinogen. Additional study procedures include measurements of weight and height, waist and hip girth, and brachial and ankle blood pressures. Electrocardiography will also be performed. A questionnaire will be administered Participants will subsequently be interviewed yearly and clinical and hospital records and death certificates will be collected to document new cardiovascular disease events. Findings regarding the prevalence and incidence of cardiovascular disease and associated risk factors will be of great public health importance in directing further at preventing these conditions in people with Type 1 diabetes of long duration.