Epidemiology of Diabetes Complications (EDC) Phase II: renewal

与2型糖尿病不同，1型糖尿病目前既不可预防也不可治愈，其发病率每年持续上升约3%。因此，1型糖尿病并发症的持续调查仍然是必要的。糖尿病并发症的流行病学（EDC）研究已经检查了25年的糖尿病并发症的患病率和发病率以及导致糖尿病并发症的危险因素。研究人群是从匹兹堡儿童医院登记处（诊断：1950-80）确定的儿童发病1型糖尿病的明确队列。所有658名参与者在研究入组时（1986-88年）参加了临床检查，随后随访长达25年，导致超过150篇同行评议的出版物。在研究的最后阶段提出了一些引人注目的观察结果，这些观察结果引起了一些问题和假设，本报告将继续加以讨论。这些包括各种促和抗糖氧化和炎症细胞因子之间日益复杂的相互作用，以及并发症的快速变化的自然史，这提供了对并发症的相互关系和特定风险因素的进一步了解，并使历史数据过时用于医疗保健和保险目的。因此，目前的建议侧重于进一步评估30年总随访期的并发症发展，从而允许合理稳定地估计40年儿童期1型糖尿病并发症的发展。这提供了记录发病风险和估计现代预期寿命的机会，即对于1965-80年诊断的人以及自可用以来糖尿病持续时间超过一半的人 HbA 1c检测和自我血糖监测。血糖，氧化和炎症应激的作用，以及他们调用的主机的反应，并发症的发展将是沿着妇女的健康问题和继续一些合作的另一个主要重点。最后，我们将评估皮肤晚期糖基化终产物作为232例患者的并发症预测因子，至少有一次此类评估。这将通过继续进行年度调查和在30年的随访中进行全面检查来促进。 相关性（参见说明）： 1型糖尿病目前既不可预防也不可治愈，其发病率每年持续上升约3%。 年人工老化因此，1型糖尿病并发症的持续调查仍然是必要的。当前 该提案不仅将提供对并发症发生率的见解，还将填补T1 D知识的空白 妇女的健康问题，以及压力和主机的反应和皮肤年龄对并发症的作用。

Unlike type 2 diabetes, where prevention is possible, type 1 diabetes is currently neither preventable nor curable and its Incidence continues to rise approximately 3% per yr. Thus, the continuing investigation of type 1 diabetes complications remains imperative. The Epidemiology of Diabetes Complications (EDC) study has examined the prevalence and incidence of and risk factors contributing to the diabetes complications for 25 yrs. The study population is a well defined cohort of childhood onset type 1 diabetes identified from the Children's Hospital of Pittsburgh Registry (diagnosis: 1950-80). All 658 participants attending a clinical exam at study entry (1986-88) have been subsequently followed for up to 25 yrs, leading to over 150 peer reviewed publications. A number of striking observations were made during the last phase of the study which have given rise to questions and hypotheses this continuation will continue to address. These include the increasingly complex interaction between various pro- and anti-glycoxidative and inflammatory cytokines, as well as the rapidly changing natural history of complications which provides further insight into the interrelationships of, and specific risk factors for, complications, and renders historic data outdated for health care and insurance purposes. The current proposal, therefore, focuses on further assessment of complication development for a total follow up period of 30 yrs, thus allowing reasonably stable estimates of complication development over 40 yrs duration of childhood onset type 1 diabetes. This gives the opportunity to document morbidity risk and to estimate life expectancy in the modern era, i.e. for those diagnosed in 1965-80 and who have had more than half their diabetes duration since the availability of HbA1c testing and self monitoring of blood glucose. The roles of glycemic, oxidative and inflammatory stress, and the host's responses they invoke, on complication development will be another major focus along with women's health issues and continuing a number of collaborations. Finally, we will evaluate skin advanced glycosylation end products as a complication predictor for 232 individuals with at least one such assessment. This will be facilitated by continuing the annual surveys and, at 30 yrs of follow up, a full exam. RELEVANCE (See instructions): Type 1 diabetes is currently neither preventable nor curable and its incidence continues to rise about 3% per yr. Thus, the continuing investigation of type 1 diabetes complications remains imperative. The current proposal will not only provide insight on complication incidence, but also fill gaps in knowledge on T1D women's health issues, and the role of stress and host's response and skin AGE on complications.