SCI REP:2型糖尿病患者视网膜病变发生发展的预测因素!

2017-07-08 xing.T MedSci原创

总之,糖尿病病程延长、血糖和血脂控制较差、较高的血压是DR发生/进展的主要预测因子。平均累积的临床舒张压是最强的血压相关预测因子。

糖尿病视网膜病变(DR)是一种慢性微血管并发症,预后较差。近日,Scientific reports 杂志上发表了一篇研究文章,研究人员的目的是在每年进行眼科检查中位随访6年的544名2型糖尿病高危患者中评估DR发生/发展的预测因子。研究人员采用颈动脉股脉搏波速度监测动态血压和主动脉硬化程度。研究人员采用Cox多因素分析来评估DR的发生或进展的独立预测因子。在随访期间,156例患者是新发生或恶化的DR患者,DR发生或恶化的患者糖尿病病程较长,具有较高的动态和诊所血压水平,较高的主动脉硬化程度,以及较差的血糖控制,相比于那些为发生/进展的DR患者。在调整了基线视网膜病变患病率、年龄、性别,在随访过程中,糖尿病病程较长(P<0.001)、较高的基线动态BPs(P=0.013、24小时舒张压)以及较高的平均糖化血红蛋白累积暴露(P<0.001)、临床舒张压(P<0.001)和低密度脂蛋白胆固醇(P=0.05)是DR发生和进展的独立预测因子。BP参数是DR发生/发展的唯一预测因子。总之,糖尿病病程延长、血糖和血脂控制较差、较高的血压是DR发生/进展的主要预测因子。平均累积的临床舒张

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    2017-07-12 haige

    学习了!

    0

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GetPortalCommentsPageByObjectIdResponse(id=219920, encodeId=b0cf219920d6, content=能否发展出一种预测算法?, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/04/24/1c2dbd6706e64df33befd6663f1d6b37.jpg, createdBy=94f61661779, createdName=lyh994, createdTime=Sat Jul 08 11:00:48 CST 2017, time=2017-07-08, status=1, ipAttribution=)]
    2017-07-10 zutt
  5. 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  6. 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  7. 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  8. 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channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib2JlGvwpAibiaovVhfA9DbO7X7JLGGjM4Cic6oMgxLdnuS9piaP9cnG2OwIbkzHvX0qzS1boibyYNqR5vHZu7HQs5EIB/0, createdBy=298d1398341, createdName=lou.minghong, createdTime=Sun Jul 09 04:35:40 CST 2017, time=2017-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=219942, encodeId=8442219942cb, content=学习,学习发展, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyhb9xDeHojCicsdRdyC3XXdGk2ib9yLypZuHN06WeW4HO8WN0GGrgEfvnTX8gsckof05GHOU5OM4Mvx/0, createdBy=9cee1982656, createdName=执着追梦, createdTime=Sat Jul 08 12:47:19 CST 2017, time=2017-07-08, status=1, ipAttribution=), 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    2017-07-09 lou.minghong

    学习了谢谢分享!

    0

  9. 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    2017-07-08 执着追梦

    学习,学习发展

    0

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    2017-07-08 lyh994

    能否发展出一种预测算法?

    0

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该荟萃分析结果表明相比DPP-4is,SGLT-2is能够显著降低HbA1c、FPG和体重,而没有增加在糖尿病治疗中的低血糖风险。

Diabetes Care:1型和2型糖尿病青年周围神经病变患病率及危险因素!

由此可见,青年糖尿病患者DPN的高发病率是引起关注的原因,并建议进行早期筛查和更好的风险因素管理。解决血糖控制不良和血脂异常对年轻人干预可以预防或延缓导致神经病变的并发症。

JCEM:增加血清25羟维生素D状况对糖尿病患者血糖控制的影响!

由此可见,补充维生素D,最小剂量为100µgr/d(4000IU/d),可明显降低血清FPG、HbA1c、HOMA-IR指数,并有助于2型糖尿病患者的血糖控制和改善胰岛素敏感性。

Diabetes Care:丙型肝炎病毒成功治疗后2型糖尿病患者血糖控制得到改善!

DAA为基础的HCV根除具有改善糖尿病患者的血糖控制的作用,其证据为降低平均HbA1c和减少胰岛素的使用。SVR的这些内分泌益处为所有糖尿病患者考虑抗病毒治疗提供了额外的理由。

Diabetes Obes Metab:老年2型糖尿病患者采用吡格列酮与其他治疗发生膀胱癌的风险比较!

由此可见,吡格列酮治疗与膀胱癌风险升高相关,相比于DPP-4s和磺脲类药物。升高的风险发生在治疗前2年内,并在停药后有所减弱。吡格列酮的相对有效性应与较小的膀胱癌风险绝对增加相权衡。

JCEM:2型糖尿病成人心血管疾病与预期寿命有何关系?

在年轻的2型糖尿病亚洲患者中,尤其是心血管合并症患者其寿命比非糖尿病患者要短。因此,这些人需要特别注意,以防止进一步降低预期寿命。