2型糖尿病的微血管并发症有或没有MASLD:EPSOMIP研究,初级保健队列研究
Martin Bergram1, Stergios Kechagias2, Fredrik Iredahl3,4
1Primary Health Care Center Ekholmen, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden. martin.bergram@liu.se.
BMC primary care
|November 11, 2025
概括
在初级保健中,患有代谢功能障碍相关的脂肪性肝病 (MASLD) 的2型糖尿病患者没有增加病,神经病变或视网膜病变的风险. 然而,MASLD的晚期纤维化与更高的微血管并发症风险相关.
科学领域:
- 内分泌学 在内分泌学.
- 肝病学 肝病学是一种肝病学.
- 腎臟病學 (nephrology) 是一種醫學.
- 眼科医生 眼科 眼科
- 神经学 神经学
背景情况:
- 关于2型糖尿病患者与代谢功能障碍相关的脂肪性肝病 (MASLD) 的微血管并发症风险存在不一致的发现.
- 许多先前的研究都是在专业环境中进行的,因此需要基于初级保健的研究.
- 这项研究调查了MASLD与慢性病,视网膜病变,神经病变和糖尿病足在初级保健环境中的关联.
研究的目的:
- 探索MASLD与2型糖尿病患者的关键微血管并发症在初级保健环境中的关联.
- 为了澄清患有MASLD的患者慢性病,视网膜病变,神经病变和糖尿病足的风险.
- 为了解MASLD对各种医疗保健环境中糖尿病并发症的影响做出贡献.
主要方法:
- 从初级保健机构招募2型糖尿病参与者.
- 通过MRI-PDFF (MASLD ≥5%) 或CAP (MASLD ≥248 dB/m) 评估肝脏甘油三含量.
- 使用VCTE (晚期纤维化≥10kPa) 评估肝纤维化,并从医疗记录中收集并发症数据.
主要成果:
- 在308名参与者中,58.8%患有MASLD;6.5%患有晚期纤维化.
- 在MASLD和非MASLD组之间没有发现神经病变,视网膜病变或慢性病的显著差异.
- 晚期纤维化的MASLD与微血管并发症风险增加有关.
结论:
- 在初级保健中患有MASLD的2型糖尿病患者没有表现出患慢性病,神经病变或视网膜病变的风险增加.
- 这些发现与之前的研究一致,表明不同人群和不同环境中的风险差异.
- 在MASLD患者中存在晚期纤维化,因此需要进一步关注微血管并发症风险.
相关概念视频
Diabetes Mellitus: Type 2 and Gestational
4.3K
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
4.3K
Diabetes: Symptoms, Diagnosis, and Complications
2.0K
For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
2.0K
Diabetes Mellitus: Overview and Type I Subtype
4.8K
Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
4.8K
Pathophysiology of Diabetes
3.1K
Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
3.1K
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
339
Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
339
Diabetes: Management and Pharmacotherapy
853
The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
853


