The determinants of complication trajectories in American Indians with type 2 diabetes.

摘要: BACKGROUNDWe aimed to determine whether metabolic syndrome (MetS) affects longitudinal trajectories of diabetic complications, including neuropathy, cardiovascular autonomic neuropathy (CAN), and kidney disease in American Indians with type 2 diabetes.METHODSWe performed a prospective study where participants underwent annual phenotyping outcome measurements. The updated National Cholesterol Education Program criteria were used define MetS its individual components, using BMI instead waist circumference. Neuropathy was defined the Michigan Screening Instrument index, CAN expiration/inspiration ratio, glomerular filtration rate. Mixed-effects models evaluate associations between these outcomes.RESULTSWe enrolled 141 participants: 73.1% female, mean (±SD) age 49.8 (12.3), diabetes duration 19.6 years (9.7 years) who followed for 3.1 (1.7 years). components stable during follow-up except declining obesity cholesterol. (point estimate [PE]: 0.30, 95% CI: 0.24, 0.35) (PE: -14.2, -16.8, -11.4) worsened over time, but did not -0.002, -0.006, 0.002). We found significant interaction number time 0.05, 0.01-0.10) -0.003, -0.007, 0.001) or -0.69, -3.16, 1.76). Systolic blood pressure (SBP, unit = 10 mmHg) associated each complication: 0.23, 0.07, 0.39), -0.02, -0.03, -0.02), -10.2, -15.4, -5.1).CONCLUSIONIn longstanding diabetes, follow-up, despite improving suggesting that early intervention is necessary prevent complications such patients. Additionally, an increased rate progression, SBP complication.FUNDINGThe following are funding sources: NIH T32NS0007222, R24DK082841, R21NS102924, R01DK115687, Intramural NIDDK, NeuroNetwork Emerging Therapies, Robert Katherine Jacobs Environmental Health Initiative, E. Nederlander Sr. Alzheimer's Research, Sinai Medical Staff Foundation.TRIAL REGISTRATIONClinicalTrials.gov, NCT00340678.