实用老年医学

实用老年医学 ›› 2022, Vol. 36 ›› Issue (10): 1015-1018.doi: 10.3969/j.issn.1003-9198.2022.10.010

• 临床研究 • 上一篇    下一篇

不同发病年龄新诊断2型糖尿病病人临床特点分析

俞匀, 唐伟, 娄青林   

  1. 210024 江苏省南京市,江苏省省级机关医院内分泌科
  • 收稿日期:2021-09-21 出版日期:2022-10-20 发布日期:2022-10-21
  • 通讯作者: 唐伟,Email: drtangwei@njmu.edu.cn
  • 基金资助:
    江苏省老年健康科研项目(LKM2022012);江苏省医学重点人才项目(ZDRCC2016011);江苏省干保局课题(BJ19027);南京医科大学“专病队列”项目(NMUC2020041)

Clinical characteristics of newly diagnosed type 2 diabetic patients with different age of onset

YU Yun, TANG Wei, LOU Qing-lin   

  1. Department of Endocrinology, Jiangsu Province Official Hospital, Nanjing 210024, China
  • Received:2021-09-21 Online:2022-10-20 Published:2022-10-21

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摘要： 目的 探讨新诊断老年发病T2DM与中年发病T2DM病人临床特点的差异。 方法 选择新诊断T2DM病人1555例,根据T2DM发病年龄分为新诊断老年发病病人(972例)和新诊断中年发病病人(583例)2组。测定所有病人HbA1c、FPG、餐后2 h血浆葡萄糖(PPG)、血清肌酐(SCr)、TG、TC、LDL-C、HDL-C、尿白蛋白/肌酐(ACR)及踝肱比(ABI)并进行分析比较。 结果 (1)新诊断老年发病T2DM组的HbA1c、FPG及PPG水平显著低于新诊断中年发病T2DM组(均P<0.01),HbA1c达标率显著高于新诊断中年发病T2DM组(45.68%比33.79%,P<0.01)。(2)与新诊断中年发病T2DM组相比,新诊断老年发病T2DM组的高血压患病率、SBP水平显著升高,而TG、TC水平显著降低(均P<0.01),TG、TC达标率显著升高(P<0.01)。(3)新诊断老年发病T2DM组的糖尿病大血管并发症(冠心病、周围血管病变)及合并慢性肾脏病(CKD)比例显著高于新诊断中年发病T2DM组(P<0.01)。 结论 和新诊断中年发病T2DM病人相比,新诊断老年发病T2DM病人血糖较易控制、HbA1c更容易达标,更应重视血压的管理和达标,出现糖尿病大血管并发症(冠心病、周围血管病变)及合并CKD的比例更高。

关键词: 2型糖尿病, 发病年龄, 老年人, 血糖控制, 并发症

Abstract: Objective To explore the differences of clinical characteristics between the patients with aged-onset and middle-aged-onset newly diagnosed type 2 diabetes mellitus (T2DM). Methods A total of 1555 newly diagnosed T2DM patients were enrolled and divided into two groups according to the onset age of diabetes, including 972 aged-onset patients(aged≥60 years old)and 583 middle-aged-onset patients(aged 40-59 years old). The levels of glycosylated hemoglobin(HbA1c), fasting plasma glucose(FPG), postprandial glucose(PPG), serum creatinine(SCr), triglyceride(TG), total cholesterol(TC), low-density lipoprotein cholesterol(LDL-C), high-density lipoprotein cholesterol(HDL-C), albumin creatinine ratio(ACR) and ankle-brachial index(ABI) were measured and compared between the two groups. Results The levels of HbA1c, FPG and PPG in the patients with aged-onset newly diagnosed T2DM were significantly lower than those in the patients with middle-aged-onset newly diagnosed T2DM(all P<0.01). Aged-onset patients had higher control target rate of HbA1c than middle-aged-onset patients ( 45.6% vs 33.79%, P<0.01). Compared with middle-aged-onset patients, aged-onset patients had significantly higher prevalence of hypertension and higher levels of systolic blood pressure, while significantly lower levels of TG and TC (all P<0.01), and had significantly higher control rates of TG and TC (all P<0.01). Aged-onset patients showed significantly higher proportions of diabetic macrovascular complications (coronary heart disease and peripheral vascular disease) and chronic kidney disease (CKD) compared with middle-aged-onset patients (all P<0.01). Conclusions Compared with the patients with middle-aged-onset newly diagnosed T2DM, the patients with aged-onset newly diagnosed T2DM are more likely to control glucose levels and achieve HbA1c target. We should pay more attention to the management and control of blood pressure. The patients with aged-onset newly diagnosed T2DM have significantly higher proportions of diabetic macrovascular complications and CKD.

Key words: type 2 diabetes mellitus, onset age, aged, glucose control, complication

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