Vaskuläre Erkrankungen bei 534 Schweizer Diabetikern im Rahmen einer multinationalen Studie

Summary

In Switzerland 278 diabetic men and 256 women in the age group 35 to 54 were examined for the presence of angiopathic lesions, according to a standardized protocol of a multinational study comprising 6,695 diabetics from 14 countries. The diabetics were distributed according to sex, age, and duration of the disease into groups of equal size.

Macro-angiopathy, as the sum of coronary heart disease, stroke, and vascular disease of the legs was found in 28% of men and in 29% of women in the Swiss group. The prevalence of myocardial infarction alone was 6.8% in men and 5.5% in women. These rates did not differ from those found in the other national groups. Micro-angiopathy was found in the form of retinopathy in 35% and as nephropathy in 32% of the Swiss diabetics. These rates were not different from those of all groups. Severe retinopathy was found more frequently in Swiss diabetics than in the whole study. Micro-angiopathy was strongly related to duration, hypertension, and type of treatment in all centres. Japanese diabetics showed a higher frequency of micro-angiopathy, although macrovascular disease was found at a low rate.

Systolic blood pressure (BP) in the Swiss diabetics did not differ from the results of the whole group. In 14% of the Swiss diabetic men and in 18% of the women, systolic BP was over 160 mmHg. These rates were remarkably higher than in an age- and sex-matched sample of a randomly selected sample of a Swiss population (3.2% in men, 2.4% in women). Cholesterol was high in the Swiss diabetic groups, whereas body mass index was in the intermediate range. Of the Swiss diabetic men 38% smoked regularly. The frequency of coronary heart disease in Swiss men and women was similar. This is different from the lower rate usually found in non-diabetic women.

Age, and not duration of the disease was the most important factor relating to macro-angiopathy. The different rates of macro- and microvascular complications in various populations, selected according to the same protocol, suggests that the risk factors for macrovascular disease differ from those of microvascular complications. Race, nutrition, treatment, exercise, and hypertension may further influence the prevalence of angiopathy in diabetics of same sex, age, and duration of the disease.