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目的前期研究表明身材矮小与心血管疾病相关,但其与微血管并发症的关系尚不明确。因此,本研究旨在探讨成人患者身高与糖尿病微血管并发症患病率的关系。研究设计及方法这项横断面、纵向研究纳入了FinnDaine研究的3,968名1型糖尿病成人患者和糖尿病控制及其并发症试验(DCCT)研究的1,246名成人糖尿病患者。在FinnDaine研究中,糖尿病肾病定义为尿白蛋白分泌率≥300mg/24h,需要透析或肾脏移植。视网膜病变分为背景性和增殖性(需激光治疗)病变两种。DCCT研究采用原肾病(1～6级)和视网膜病变(糖尿病视网膜病变早期治疗研究)分级标准。结果在FinnDaine研究中,身高小于成人身高QL的患者发生糖尿病肾病(OR1.71,95%CI1.44～2.02)和需接受激光治疗的糖尿病视网膜病变(OR1.66,95%CI1.43～1.93)的风险明显增高。同样,在DCCT研究中,身高小于QL的患者4～6级糖尿病肾病(HR2.70,95%CI1.59～3.59)和增殖性视网膜病变(HR2.06,95%CI1.15～3.71)的发病风险明显增高。在FinnDaine研究中,这种相关性主要表现在糖尿病儿童身上。而在DCCT研究中,大多数糖尿病患者起病年龄大于18岁,未显示出肾病与儿童期糖尿病相关。结论身材矮小与1型糖尿病患者微血管并发症相关。
PURPOSE Previous studies have shown that short stature is associated with cardiovascular disease but its relationship with microvascular complications is not yet known. Therefore, this study aimed to investigate the relationship between the height of adult patients and the prevalence of diabetic microvascular complications. Study Design and Methodology This cross-sectional, longitudinal study enrolled 1,366 FinnDaine adult patients with type 1 diabetes and 1,246 adults with diabetes from the Diabetes Control and Complications Trial (DCCT) study. In the FinnDaine study, diabetic nephropathy was defined as urinary albumin excretion rate ≥300 mg / 24h requiring dialysis or kidney transplant. Retinopathy is divided into two kinds of background and proliferative (laser treatment) lesions. The DCCT study used primary kidney disease (grades 1-6) and retinopathy (diabetic retinopathy early treatment study) grading standards. Results In the FinnDaine study, diabetic nephropathy (OR 1.71, 95% CI 1.44-2.02) and diabetic retinopathy requiring laser treatment (OR 1.66, 95% CI 1.43-1.93 ) Significantly increased the risk. Similarly, in the DCCT study, patients with grade 4 to 6 diabetic nephropathy (HR 2.70, 95% CI 1.59-3.59) and proliferative retinopathy (HR 2.06, 95% CI 1.15-3.71) The risk of onset was significantly higher. In the FinnDaine study, this correlation is mainly manifested in children with diabetes. In the DCCT study, however, most people with diabetes onset were older than 18 and did not show that kidney disease was associated with childhood diabetes. Conclusion Short stature is associated with microvascular complications in type 1 diabetic patients.