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老年2型糖尿病住院患者糖脂代谢、慢性并发症及临床用药的现状分析

来自:中国糖尿病杂志  编辑:尹艳华 孙海燕 赵立 丁晓颖 顾鸣宇 苏|点击数:|2015-04-30

  糖尿病临床研究

  【摘要】 目的 了解老年糖尿病患者血压、血糖、血脂及用药情况,探讨老年T2DM慢性并发症的危险因素。方法 回顾性分析我科住院的447例60岁以上T2DM患者(>60岁T2DM组)的临床资料,将其与>60岁正常体检者(>60岁NC组)及<60岁T2DM患者(<60岁T2DM组)进行比较,并根据BMI结果将>60岁T2DM组再分为体重正常亚组、超重亚组及肥胖亚组,比较各亚组代谢指标的差异。 结果 >60岁T2DM组HbA1c、2 hPG均高于>60岁NC组及<60岁T2DM组,HDL-C低于>60岁NC组(P<0.05)。超重或肥胖亚组比例高(52.8%)。随BMI增加,SBP、SUA、UAlb/Cr及24 hUAlb均增加(P<0.05),LDL-C有增加趋势,eGFR有下降趋势,但差异无统计学意义(P>0.05)。Logistic回归分析显示,年龄、病程、性别、SBP及SUA是其危险因素。 结论 本研究中T2DM诊断主要依靠健康体检和糖尿病并发症发现,且大多肥胖与超重。血脂中,LDL-C上升,均值为(2.86±0.97)mmol/L,>2.60 mmol/L。糖尿病慢性并发症危险因素为年龄、病程、性别、SBP及SUA。

  【关键词】糖尿病,2型;糖脂代谢;并发症;临床分析

  【Abstract】Objective To explore characteristics of bloodpressure, blood glucose, lipids, drug use and the risk factors of chronic diabetic complications in the elderly type 2diabetic patients. Methods We retrospectively analyzed the clinical data of 447 patients above age of 60 years with T2DM consecutively admitted to the Department of Endocrinology. The non-diabetic population aged over 60 years and the T2DMpatients under the age of 60 years were recruited as controls.Furthermore, we investigatedthe differencesin the metabolic indicators among groups classified by BMI. Results HbA1c and PPG were significantly higher in the elderly diabetic patients thanin the elderlynon-diabetic population and in patients under the age of 60 with T2DM, while HDL-C was lower in elderly diabetic patient than in the controls(P<0.05). A proportion of patients with overweight or obese were 52.8%.Along with the increase of BMI, the values of blood pressure, uric acid and urine Alb/Cr were increased(P<0.05), LDL-C had an increasing trend and eGFR had a decreasing trend(both P>0.05).98.0% of the patients with T2DM were suffering from diabetic complications. Logistic regression analysis showed that the age, duration of disease, female, SBP and UA were risk factors for diabetic chronic complications. Conclusion In this study, T2DM are diagnosed mainly by health examination and finding diabetic complications, and most of the patients suffer from overweight or obesity. The chronic diabetic complications are highly prevalent and the risk factors include the age, the duration of disease, female, SBP and UA.

  【Key words】Diabetes mellitus,type2;Glucose and lipid metabolism;Complication

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