【青少年1型糖尿病视网膜病变与早期动脉粥样硬化改变的相关性分析——初步报告】。

Barbara Głowińska-Olszewska, Mirosława Urban, Beata Urban, Joanna Tołwińska
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摘要

目的:最近的研究表明,晚期糖尿病视网膜病变与动脉粥样硬化之间存在相关性。目前还没有发现糖尿病视网膜病变与年轻1型糖尿病患者早期心血管系统疾病之间的可能关系。该研究的目的是分析1型糖尿病青少年糖尿病视网膜病变与早期动脉粥样硬化改变之间的相关性。研究设计与方法:28例青少年1型糖尿病患者,年龄17.6+/-1.4岁,病程7.9+/-3.1年,平均发病年龄- 9.5+/-3.7岁,平均HbA1c水平- 8.6+/-1.9%。8名患有单纯性视网膜病变的患者,从整个年轻人组中分离出来。第一个对照组由其余的1型糖尿病患者组成,根据年龄和性别选择,没有疾病并发症。第二组由11名健康的年轻人组成。超声测量肱动脉舒张- FMD及颈总动脉内膜-中膜复合体厚度,评价血管内皮功能。结果:年轻视网膜病变患者的收缩压较高:133+/-19 mmHg,而无并发症患者的收缩压为117+/-14 mmHg。与健康青年相比,1型糖尿病青年内皮功能明显受损,IMT较高。2. 青少年视网膜病变的特点是收缩压值明显高于无并发症的患者3。与无并发症的患者相比,糖尿病视网膜病变患者的IMT更高,这可能表明并发症的大血管改变比无视网膜病变的患者更早。
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[Correlation analysis between diabetic retinopathy and early atherosclerotic changes in adolescents with type 1 diabetes -- preliminary report].

Objective: Recent studies have shown a correlation between advanced diabetic retinopathy and late stages of atherosclerosis. There are no findings on a possible relation between diabetic retinopathy and diseases of the cardiovascular system at their earliest stage in young people with diabetes type 1. The purpose of the study was to analyze a correlation between diabetic retinopathy and early atherosclerotic changes in adolescents with type 1 diabetes.

Research design and methods: The study included 28 adolescents aged 17.6+/-1.4 years suffering from type 1 diabetes mellitus for 7.9+/-3.1 years, the mean age of the disease onset - 9.5+/-3.7 years, a mean level of HbA1c - 8.6+/-1.9%. Eight patients with developing simple retinopathy, were separated from the whole group of young people. First control group consisted of the remaining patients with type 1 diabetes chosen with regard to age and sex, without disease complications. Second control group consisted of 11 healthy young people. The function of endothelium by measuring the brachial artery dilatation -- FMD and the intima-media complex thickness of the common carotid arteries were evaluated ultrasonographically.

Results: Young people with retinopathy had higher systolic pressure: 133+/-19 mmHg in comparison with patients without complications: 117+/-14 mmHg (p<0.05) and healthy people: 115+/-8 mmHg (p<0.05). All patients with diabetes showed significantly lower FMD (7.6+/-5.1%, p<0.05). In the group with retinopathy, FMD equaled 7.8+/-4.1% (p=0.04) and in the group without retinopathy - 7.6+/-5.5% (p<0.05) in comparison with 12.1+/-5.1% in healthy volunteers. Significantly higher IMT was found in all patients with diabetes in comparison with healthy young people: 0.49+/-0.06 vs. 0.42+/-0.03 mm (p<0.001). Patients with retinopathy had a significantly higher value of IMT in comparison not only with controls but also with patients without complications: 0.56+/-0.06 vs. 0.47+/-0.03 mm (p<0.001).

Conclusions: 1. Young people with type 1 diabetes had a significantly impaired function of endothelium and higher IMT in comparison with healthy young people. 2. Adolescents with retinopathy were characterized by significantly higher values of systolic arterial blood pressure when compared to patients without complications 3. Higher IMT was found in patients with diabetic retinopathy in comparison with patients without complications, which may suggest that macrovascular changes are more advanced in case of complications than in patients without retinopathy.

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