[Diabetes mellitus in the aged. 4. Cardiovascular risk profile of aged long term diabetics from the viewpoint of their kidney function]. / Untersuchungen zum Diabetes mellitus im hohen Lebensalter. 4. Mitteilung: Das kardiovaskuläre Risikoprofil alt gewordener Langzeit-diabetiker im Blickwinkel ihrer Nierenfunktion.

The cardiovasculary risk profile of 138 old grown long term diabetics (mean age 71,1 years, mean duration of the disease 19,9 years) was analysed in the frame of the so called metabolic syndrome and put in relation to the corresponding value of serum creatinine. With increasing concentration of creatinine the mean value of diabetes-associated cardiovasculary risk factors grew with old age, where only the frequency of hyperuricaemia correlated positively to the creatinine level. With comparable level of uric acid in serum the part of pathological increasing of creatinine in older age was more marked distinctly than with younger long term diabetics et respective time of disease (n = 112, mean age 45,7 years, mean duration of the disease 19,6 years). 42,0 per cent of the younger and 60.9 per cent of the older long term diabetics showed increased values of serum creatinine (p less than 0,01). The reduction of the cardiovasculary risk factors should also be forced with old grown long term diabetics.

[Correlation of serum creatinine concentration, retinopathy and frequency of hypertension in relation to the age of long-term diabetics in a rural population]. / Beziehungen zwischen Serumkreatininkonzentration, Retinopathie- und Hypertoniefrequenz in Abhängigkeit vom Lebensalter bei Langzeitdiabetikern einer ländlichen Population.

274 diabetics with a duration of the disease between 15 and 54 years were examined regarding the relations between their renal function, the frequency of retinopathy and hypertension and their age. 41.6% of the patients showed an increased creatinine value, a retinopathy occurred in 59.5% of all diabetics. In the increase of creatinine as well as in the retinopathy there was a close correlation of the retinopathy and the duration of the disease, but the retinopathy was significantly more frequent in younger persons. It is nearly always accompanied by hypertension. The latter way found in 69.3% of the patients. The duration of diabetes seems to have no influence on the frequency of hypertension, but the level of creatinine in patients under 60 does. Increased creatinine values as well as a retinopathy and hypertension were preponderant in males of this age group. References to the reduction of the high frequency of hypertension, retinopathy and of increased creatinine are given.

[Diabetes mellitus in advanced old age. 3. Cardiovascular risk patterns in long-term diabetics who have grown old compared to newly detected cases of late-onset diabetics]. / Untersuchungen zum Diabetes mellitus im hohen Lebensalter. 3. Mitteilung: Das kardiovaskuläre Risikoprofil alt gewordener Langzeitdiabetiker im Vergleich zu neuentdeckten Altersdiabetikern.

The investigation of each 131 long term diabetics of 60 years and older (average: 71 years) with a mean diabetes duration of 19.7 years with respect to the presence of 5 classical risk factors of the "metabolic syndrome" yielded a significant more seldom appearance of hypertension and overweight (p less than 0.01) in comparison to newly detected old age diabetics (group comparison done with the principle of biostatical gemini forming), while the frequencies of hypercholesterolemia, hypertriglyceridemia and hyperuricemia didn't differ in the two groups. Though the cardio-vascular risk profile of the long term diabetics (mean value: 2.28 risk factors per patient) shows more favourable with this (selection by overmortality of diabetics with several risk factors already with shorter disease duration?) than with newly detected diabetic patients (mean value: 2.85 risk factors per patient) is demanded on account of the negative influence of the cardiovascular risk factors on the development of macroangiopathy to mind these pathogenic magnitudes of influence also with longer duration of the diabetes stronger than before now in higher ages too.

[The cardiovascular risk profile of long-term diabetics and its relation to kidney function]. / Das kardiovaskuläre Risikoprofil des Langzeitdiabetikers und seine Beziehungen zur Nierenfunktion.

Of 250 diabetics with a duration of the disease between 15 and 54 years the relations between the renal function and the cardiovascular risk profile were examined. The clearly increased serum creatinine values the frequency of persons with overweight was lower than in diabetics with very favourable creatinine levels. The increasing concentration of the serum led to an increase of the frequency of hyperuricaemia, whereas the frequencies of hypertension hypertriglyceridaemia and hypercholesterolaemia did not show any significant changes. The habits of smoking of long-term diabetics with and without renal insufficiency did not differ from each other qualitatively. Particularly after the 50th year of age long-term diabetics more frequently had diabetic blood-relatives than newly detected diabetic patients of the same age. Patients with familial occurrence of diabetes (relatives of 1st degree) in comparison to diabetics without known diabetic relatives showed an identical cardiovascular risk profile, so that there is no influence of the heredity of diabetes on the formation of the non-diabetic sizes of influence of the metabolic syndrome.

[The cardiovascular risk profile of the long-term diabetic]. / Das kardiovaskuläre Risikoprofil des Langzeitdiabetikers.

The long-term diabetic is in a considerable degree endangered by macroangiopathy. With a high probability their profile is influenced by the factors of cardiovascular endangering overweight (Broca-weight greater than or equal to 110%), hypertension (RR greater than or equal to 160/95 mm Hg), hypertriglyceridaemia (greater than or equal to 200 mg/dl), hypercholesterolaemia (greater than or equal to 260 mg/dl) and hyperuricaemia (greater than or equal to 6.5 mg/dl in male and greater than or equal to 6.0 mg/dl in female). Our analysis of the profile of the cardiovascular risk of 217 long-term diabetics with an average duration of the disease of 19.8 years and an average age of 60.2 years showed in comparison to normal persons an increased frequency of hypertension, hypertriglyceridaemia, hypercholesterolaemia and hyperuricaemia, whereas the weight did not differ from a normal population. Taking into consideration the same age structure the association of the examined 5 signs of risk is less narrow in the long-term diabetic than in the newly detected diabetic. With growing age the values of uric acid of the serum increase; in long-term diabetics their concentration surpasses that one of newly detected diabetic patients. From the point of view of preventive medicine factors of cardiovascular risk must be recognized already in the newly detected diabetes of type I or II as well as in disturbed glucose tolerance and, as far as possible, be influenced in the sense of an improvement of the profile of the risk.