2型糖尿病视网膜病变受内源性胰岛素残留分泌水平的影响,而非神经病变。

Diabete & metabolisme Pub Date : 1995-12-01
M Boz, A J Scheen, P L Gerard, M J Castillo, P J Lefebvre
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引用次数: 0

摘要

回顾性分析了132例2型糖尿病患者的资料,探讨代谢控制和残留胰岛素分泌对神经病变和视网膜病变(两种最常见的退行性糖尿病并发症)的影响。根据代谢控制情况对患者进行分类(平均HbA1C <或>或= 8%;参考值:3-6%)和剩余内源性胰岛素分泌(空腹血浆c肽水平<或>或= 0.600 nmol/l)。代谢控制不良的患者(32/64 = 50%)比代谢控制良好的患者(17/68 = 25%;P < 0.005)。在两个亚组中,内源性胰岛素分泌水平不影响神经病变的患病率。代谢控制程度对视网膜病变的影响小于神经病变(HbA1C >或= 8%亚组为37.5%,HbA1C < 8%亚组为25%;P < 0.10),但受剩余胰岛素分泌的影响。事实上,在代谢控制不充分的患者中,内源性胰岛素分泌较高的患者视网膜病变的患病率显著增加(51.4 vs 20.6%, p < 0.02),因此可能更高的胰岛素抵抗。此外,在视网膜病变患病率较高的亚组中观察到较高的收缩压。这些结论通过多变量分析得到证实。因此,在2型糖尿病中,神经病变本质上受代谢控制程度的影响,而视网膜病变也受剩余内源性胰岛素分泌水平和收缩期高血压的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Retinopathy, but not neuropathy, is influenced by the level of residual endogenous insulin secretion in type 2 diabetes.

The files of 132 patients with Type 2 diabetes were retrospectively studied to characterize the influence of metabolic control and residual insulin secretion on neuropathy and retinopathy, the two most frequent degenerative diabetic complications. Patients were classified according to their metabolic control (mean HbA1C either < or > or = 8%; reference values: 3-6%) and residual endogenous insulin secretion (fasting plasma C-peptide levels either < or > or = 0.600 nmol/l). Neuropathy was more frequent in patients with poor metabolic control (32/64 = 50%) than in those adequately controlled (17/68 = 25%; p < 0.005). In both subgroups, the level of endogenous insulin secretion did not influence the prevalence of neuropathy. Retinopathy was less effected than neuropathy by the degree of metabolic control (37.5% in the subgroup with HbA1C > or = 8% v.s. 25% in the subgroup with HbA1C < 8%; p < 0.10), but was influenced by residual insulin secretion. Indeed, in patients with inadequate metabolic control, the prevalence of retinopathy was significantly increased in those with higher endogenous insulin secretion (51.4 versus 20.6%, p < 0.02) and thus probably higher insulin resistance. Furthermore, higher systolic arterial blood pressure was observed in the subgroups with a higher prevalence of retinopathy. Such conclusions were confirmed using multivariate analysis. Thus, in Type 2 diabetes, neuropathy is essentially affected by the degree of metabolic control, whereas retinopathy is also influenced by the level of residual endogenous insulin secretion and the presence of systolic hypertension.

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