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首页> 外文期刊>European Journal of General Medicine >Generalized Vascular Damage Including Glomerular Dysfunction in Newly-Detected Type 2 Diabetic Patients
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Generalized Vascular Damage Including Glomerular Dysfunction in Newly-Detected Type 2 Diabetic Patients

机译：新检测到的2型糖尿病患者的全身血管损伤，包括肾小球功能障碍

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Aim: Diabetes mellitus (DM) is considered a vascular disease, we intended to determine prevalence and nature of generalized and glomerular vascular abnormalities the moment it is diagnosed (ND-DM) in a cohort of patients with Arabic descent. Over 9 months, 216 out of 1208 asymptomatic Saudies were referred by the Primary Care Physicians on having risk factors for future development of DM for DM screening. Methods: For the 54 ND-DM patients and 18 non-diabetic controls, clinical examination including body mass index (BMI) and waist:hip ratio (WHR), ultrasound determination of common carotid artery (CCA) intimal-medial thickness (IMT), hemoglobin A1c (A1c), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), CRP, albuminuria, serum creatinine (sCr), and glomerular filtration rate (eGFR) were done. Results: About 4.5% were unaware of their diabetes and they had significant (35/54 vs 5/18 p=0.01) preclinical atherosclerosis (increased IMT and/or atheromatous plaques) with similar age, HDL-C, CRP and eGFR compared to controls. Also, they had pathologic microalbuminuria ([μA] 145.4±201.4 vs 18.9±7.1, p=0.013) with higher BMI (29.5±3.6 vs 27.2±1.8, p=0.043), WHR (0.94±0.12 vs 0.79±0.1, p=0.001), TC (5.1±0.9 vs 3.8±0.6, p=0.001) and TG (2.3±0.9 vs 1.2±0.4, p=0.001) compared to controls. Diabetic nephropathy (DN), as inferred from glomerular damage marker μA was significantly prevalent (17/54, p=0.014) in ND-DM patients. Those with DN had more IMT (0.96±0.1 vs 0.77±0.1, p=0.0001), WHR (0.98±0.1 vs 0.91±0.13, p=0.037), TC (5.4±0.7 vs 4.9±0.9, p=0.049) and TG (2.7±0.4 vs 2.02±0.4, p=0.012), lower eGFR (86.4±12 vs 104.1±13, p=0.0001), older age (40.9±5 vs 37.9±4, p=0.028) and worse glycamic control (A1c=8.1±1.6 vs 7.3±1.5, p=0.048). Also, diabetic retinopathy (DR) was significantly prevalent (n=19) in ND-DM patients (p=0.047). Interestingly, DN and DR, were significantly correlated with each other (r=0.841, p=0.0001) and with IMT (r=0.38, p=0.005 and r=0.35, p=0.009, respectively). Conclusion: The newly-detected Saudi diabetics already had more vascular changes including glomerular damage than normal glucose-tolerant subjects with clustering of risk factors in particular abdominal obesity, and dyslipidaemia.
机译：目的：糖尿病（DM）被认为是一种血管疾病，我们打算确定在阿拉伯血统患者队列中被诊断出（ND-DM）时的普遍性和肾小球血管异常的患病率和性质。在9个月内，初级保健医师转诊了1208名无症状的沙特阿拉伯患者中的216名，因为他们具有未来发展DM筛查DM的危险因素。方法：对54例ND-DM患者和18例非糖尿病对照者进行临床检查，包括体重指数（BMI）和腰围：臀围比率（WHR），超声测定颈总动脉（CCA）内膜中膜厚度（IMT） ，血红蛋白A 1c （A 1c ），总胆固醇（TC），甘油三酸酯（TG），高密度脂蛋白胆固醇（HDL-C），CRP，蛋白尿，血清进行肌酐（sCr）和肾小球滤过率（eGFR）。结果：约4.5％的人不知道自己的糖尿病，与年龄，HDL-C，CRP和eGFR相比，他们的临床前动脉粥样硬化（IMT和/或动脉粥样斑块增加）显着（35/54 vs 5/18 p = 0.01）。控制。此外，他们具有病理性微量白蛋白尿（[μA] 145.4±201.4 vs 18.9±7.1，p = 0.013），BMI较高（29.5±3.6 vs 27.2±1.8，p = 0.043），WHR（0.94±0.12 vs 0.79±0.1，p与对照组相比，TC（= 0.001），TC（5.1±0.9 vs 3.8±0.6，p = 0.001）和TG（2.3±0.9 vs 1.2±0.4，p = 0.001）。从肾小球损伤标志物μA推断，糖尿病性肾病（DN）在ND-DM患者中非常普遍（17/54，p = 0.014）。 DN患者的IMT更高（0.96±0.1 vs.0.77±0.1，p = 0.0001），WHR（0.98±0.1 vs 0.91±0.13，p = 0.037），TC（5.4±0.7 vs 4.9±0.9，p = 0.049）和TG（2.7±0.4 vs 2.02±0.4，p = 0.012），eGFR较低（86.4±12 vs 104.1±13，p = 0.0001），老年人（40.9±5 vs 37.9±4，p = 0.028）和较差的血糖控制（A 1c = 8.1±1.6 vs 7.3±1.5，p = 0.048）。此外，在ND-DM患者中糖尿病视网膜病变（DR）显着流行（n = 19）（p = 0.047）。有趣的是，DN和DR彼此之间显着相关（r = 0.841，p = 0.0001），与IMT显着相关（r = 0.38，p = 0.005，r = 0.35，p = 0.009）。结论：新发现的沙特糖尿病患者的血管变化（包括肾小球损害）比正常的葡萄糖耐量受试者高，这些危险因素聚集在特别是腹部肥胖和血脂异常中。

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