Investigation on the clinical characteristics and risk factors for chronic complications in hospitalized early-onset type 2 diabetic mellitus patients
10.3760/cma.j.issn.1673-4904.2017.09.001
- VernacularTitle:住院早发2型糖尿病患者临床特征及慢性并发症相关危险因素分析
- Author:
Fang WANG
;
Liyong ZHONG
- Keywords:
Diabetes mellitus;
type 2;
Diabetes complications;
Risk factors;
Disease attributes
- From:
Chinese Journal of Postgraduates of Medicine
2017;40(9):769-773
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical characteristics and the risk factors for chronic complications in hospitalized early-onset type 2 diabetic mellitus patients. Methods The clinical data of 462 hospitalized type 2 diabetic mellitus patients were retrospectively analyzed. The patients were divided into early-onset group (age of diagnosis ≤40 years, 120 cases) and late-onset group (age of diagnosis>40 years, 342 cases) according to the age of diagnosis of diabetes. The clinical characteristics were compared and risk factors for chronic complications of early-onset type 2 diabetes were explored. Results The percentage of family history of diabetes, fasting plasma glucose, triglyceride and diastolic blood pressure in early-onset group were significantly higher than those in late-onset group:70.0%(84/120) vs. 52.3%(179/342), (8.68 ± 3.08) mmol/L vs. (8.07 ± 2.74) mmol/L, 1.69 (1.06, 2.92) mmol/L vs. 1.48 (1.07, 2.24) mmol/L and (84 ± 10) mmHg (1 mmHg = 0.133 kPa) vs. (81 ± 10) mmHg, and there were statistical differences (P<0.01 or <0.05). The incidence of hypertension, systolic blood pressure and 2h C-peptide in early-onset group were significantly lower than those in late-onset group: 44.2%(53/120) vs. 60.2% (206/342), (134 ± 17) mmHg vs. (138 ± 18) mmHg and (3.99 ± 2.47) μg/L vs. (4.75 ± 2.65) μg/L, and there were statistical differences (P<0.01 or < 0.05). There were no statistical differences in smoking percentage, body mass index, glycated hemoglobin, total cholesterol, low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) between 2 groups (P>0.05). The incidences of peripheral vasculopathy and cerebrovascular disease in early-onset group were significantly lower than those in late-onset group:13.3%(16/120) vs. 24.3%(83/342) and 11.7%(14/120) vs. 22.8%(78/342), but the incidence of diabetic nephropathy was significantly higher than that in late-onset group: 37.5% (45/120) vs. 27.8% (95/342), and there were statistical differences (P<0.05 or <0.01). There were no statistical differences in incidences of coronary heart disease, diabetic retinopathy and diabetic neuropathy between 2 groups (P>0.05). Multivariate Logistic stepwise regression analysis result showed that age, duration of diabetes, hypertension, smoking, levels of glycated hemoglobin and triglyceride were the risk factors for chronic complications in early-onset type 2 diabetic mellitus patients. Conclusions The clinical characteristics are different between early-onset and late-onset type 2 diabetic mellitus patients. Early-onset patients are more prone to diabetic nephropathy, while late-onset patients are prone to macrovascular diseases such as peripheral vascular disease and cerebrovascular disease. Comprehensive management should be administered for early-onset type 2 diabetic mellitus patients to prevent chronic complications especially microvascular complications.