评估日本青少年1型糖尿病患者血糖控制和糖尿病并发症随时间的变化以及与糖尿病并发症进展相关的因素。

IF 3 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Pub Date : 2023-10-18 DOI:10.1111/1753-0407.13486

Takafumi Masuda, Naoto Katakami, Hirotaka Watanabe, Naohiro Taya, Kazuyuki Miyashita, Mitsuyoshi Takahara, Ken Kato, Akio Kuroda, Munehide Matsuhisa, Iichiro Shimomura

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引用次数: 0

摘要

背景：本研究旨在评估日本青少年1型糖尿病患者血糖控制和糖尿病并发症随时间的变化，并阐明与糖尿病并发症进展相关的因素。方法：我们追踪了129例1型糖尿病患者（21.8 ± 4.1 年[平均 ± SD]，糖尿病持续时间为12.6 ± 5.7 年）长达19 年，并使用线性混合模型和决策树分析分析了糖化血红蛋白（HbA1c）和与糖尿病并发症严重程度相关的指标（估计肾小球滤过率[eGFR]、尿白蛋白排泄率[UAE]、颈动脉内膜-中膜厚度[CMT]和臂踝脉搏波速度[baPWV]）的数据。结果：尽管HbA1c和UAE水平随着时间的推移而改善，但eGFR、CIMT和baPWV恶化。决策树分析显示HbA1c与糖化白蛋白/HbA1c比值为eGFR；阿联酋的HbA1c和收缩压；CIMT的低密度脂蛋白胆固醇/高密度脂蛋白蛋白胆固醇比率、白蛋白/HbA1c比率和体重指数（BMI）；baPWV的HbA1c是相关因素。结论：在这项回顾性观察研究中，血糖控制和蛋白尿得到改善；然而，随着时间的推移，肾功能和动脉硬化恶化。糖化血红蛋白水平、血糖升高和血压与肾病进展有关。HbA1c水平、血糖升高、脂质水平和BMI与动脉粥样硬化的进展有关。

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Evaluation of changes in glycemic control and diabetic complications over time and factors associated with the progression of diabetic complications in Japanese patients with juvenile-onset type 1 diabetes mellitus

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Background

This study aimed to evaluate the changes in glycemic control and diabetic complications over time in Japanese patients with juvenile-onset type 1 diabetes mellitus and to clarify the factors associated with the progression of diabetic complications.

Methods

We tracked 129 patients with type 1 diabetes mellitus (21.8 ± 4.1 years old [mean ± SD] with a diabetes duration of 12.6 ± 5.7 years) for up to 19 years and analyzed data on glycated hemoglobin (HbA1c) and indicators related to the severity of diabetic complications (estimated glomerular filtration rate [eGFR], urinary albumin excretion rate [UAE], carotid intima-media thickness [CIMT], and brachial-ankle pulse wave velocity [baPWV]) using linear mixed model and decision tree analysis.

Results

Although the HbA1c and UAE levels improved over time, the eGFR, CIMT, and baPWV worsened. Decision tree analysis showed that HbA1c and the glycoalbumin/HbA1c ratio for eGFR; HbA1c and systolic blood pressure for UAE; low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio, glycoalbumin/HbA1c ratio, and body mass index (BMI) for CIMT; and HbA1c for baPWV were associated factors.

Conclusions

In this retrospective observational study, glycemic control and albuminuria improved; however, renal function and arteriosclerosis worsened over time. HbA1c levels, glycemic excursion, and blood pressure are associated with nephropathy progression. HbA1c levels, glycemic excursion, lipid levels, and BMI are associated with the progression of atherosclerosis.

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来源期刊

Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

2.20%

发文量

审稿时长

>12 weeks

期刊介绍： Journal of Diabetes (JDB) devotes itself to diabetes research, therapeutics, and education. It aims to involve researchers and practitioners in a dialogue between East and West via all aspects of epidemiology, etiology, pathogenesis, management, complications and prevention of diabetes, including the molecular, biochemical, and physiological aspects of diabetes. The Editorial team is international with a unique mix of Asian and Western participation. The Editors welcome submissions in form of original research articles, images, novel case reports and correspondence, and will solicit reviews, point-counterpoint, commentaries, editorials, news highlights, and educational content.