Glycemic Control and Urinary Tract Infections in Women with Type 1 Diabetes: Results from the DCCT/EDIC

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• 作者：Sara M. Lenherr^a ; ^&lowast ; ; J. Quentin Clemens^b ; Barbara H. Braffett^d ; Patricia A. Cleary^d ; Rodney L. Dunn^b ; James M. Hotaling^a ; Alan M. Jacobson^e ; Catherine Kim^c ; William Herman^c ; Jeanette S. Brown^f ; Hunter Wessells^g ; Aruna V. Sarma^b ; ^{asarma@umich.edu" class="auth_mail" title="E-mail the corresponding author} ; ; the DCCT/EDIC Research Group^&Dagger ; ; D.M. Nathan ; B. Zinman (vice-chair) ; O. Crofford (past) ; S. Genuth (past) ; J. Brown-Friday (past) ; J. Crandall (past) ; H. Engel (past) ; S. Engel (past) ; H. Martinez (past) ; M. Phillips (past) ; M. Reid (past) ; H. Shamoon (past) ; J. Sheindlin (past) ; R. Gubitosi-Klug ; L. Mayer ; S. Pendegast ; H. Zegarra ; D. Miller ; L. Singerman ; S. Smith-Brewer ; M. Novak ; J. Quin (past) ; Saul Genuth (past) ; M. Palmert (past) ; E. Brown (past) ; J. McConnell (past) ; P. Pugsley (past) ; P. Crawford (past) ; W. Dahms (deceased) ; D. Brillon ; M.E. Lackaye ; S. Kiss ; R. Chan ; A. Orlin ; M. Rubin ; V. Reppucci (past) ; T. Lee (past) ; M. Heinemann (past) ; S. Chang (past) ; B. Levy (past) ; L. Jovanovic (past) ; M. Richardson (past) ; B. Bosco (past) ; A. Dwoskin (past) ; R. Hanna (past) ; S. Barron (past) ; R. Campbell (deceased) ; A. Bhan ; D. Kruger ; J.K. Jones ; P.A. Edwards ; A. Bhan ; J.D. Carey ; E. Angus ; A. Thomas ; A. Galprin (past) ; M. McLellan (past) ; F. Whitehouse (past) ; R. Bergenstal ; M. Johnson ; K. Gunyou ; L. Thomas ; J. Laechelt ; P. Hollander (past) ; M. Spencer (past) ; D. Kendall (past) ; R. Cuddihy (past) ; P. Callahan (past) ; S. List (past) ; J. Gott (past) ; N. Rude (past) ; B. Olson (past) ; M. Franz (past) ; G. Castle (past) ; R. Birk (past) ; J. Nelson (past) ; D. Freking (past) ; L. Gill (past) ; W. Mestrezat (past) ; D. Etzwiler (deceased) ; K. Morgan (deceased) ; L.P. Aiello ; E. Golden ; P. Arrigg ; V. Asuquo ; R. Beaser ; L. Bestourous ; J. Cavallerano ; R. Cavicchi ; O. Ganda ; O. Hamdy ; R. Kirby ; T. Murtha ; D. Schlossman ; S. Shah ; G. Sharuk ; P. Silva ; P. Silver ; M. Stockman ; J. Sun ; E. Weimann ; H. Wolpert ; L.M. Aiello (past) ; A. Jacobson (past) ; L. Rand (past) ; J. Rosenzwieg (past) ; D.M. Nathan ; M.E. Larkin ; M. Christofi ; K. Folino ; J. Godine ; P. Lou ; C. Stevens ; E. Anderson (past) ; H. Bode (past) ; S. Brink (past) ; C. Cornish (past) ; D. Cros (past) ; L. Delahanty (past) ; A. deManbey (past) ; C. Haggan (past) ; J. Lynch (past) ; C. McKitrick (past) ; D. Norman (past) ; D. Moore (past) ; M. Ong (past) ; C. Taylor (past) ; D. Zimbler (past) ; S. Crowell (past) ; S. Fritz (past) ; K. Hansen (past) ; C. Gauthier-Kelly (past) ; F.J. Service ; G. Ziegler ; R. Colligan (past) ; L. Schmidt (past) ; B. French (past) ; R. Woodwick (past) ; R. Rizza (past) ; W.F. Schwenk (past) ; M. Haymond (past) ; J. Pach (past) ; J. Mortenson (past) ; B. Zimmerman (deceased) ; A. Lucas (deceased) ; L. Luttrell ; M. Lopes-Virella ; S. Caulder ; C. Pittman ; N. Patel ; K. Lee ; M. Nutaitis ; J. Fernandes ; K. Hermayer ; S. Kwon ; A. Blevins ; J. Parker ; J. Colwell (past) ; D. Lee (past) ; J. Soule (past) ; P. Lindsey (past) ; M. Bracey (past) ; A. Farr (past) ; S. Elsing (past) ; T. Thompson (past) ; J. Selby (past) ; T. Lyons (past) ; S. Yacoub-Wasef (past) ; M. Szpiech (past) ; D. Wood (past) ; R. Mayfield (past) ; M. Molitch ; D. Adelman ; S. Colson ; L. Jampol ; A. Lyon ; M. Gill ; Z. Strugula ; L. Kaminski ; R. Mirza ; E. Simjanoski ; D. Ryan ; C. Johnson ; A. Wallia ; S. Ajroud-Driss ; P. Astelford ; N. Leloudes ; A. Degillio ; B. Schaefer (past) ; S. Mudaliar ; G. Lorenzi ; M. Goldbaum ; K. Jones (past) ; M. Prince (past) ; M. Swenson (past) ; I. Grant (past) ; R. Reed (past) ; R. Lyon (past) ; O. Kolterman (past) ; M. Giotta (past) ; T. Clark (past) ; G. Friedenberg (deceased) ; W.I. Sivitz ; B. Vittetoe ; J. Kramer ; M. Bayless (past) ; R. Zeitler (past) ; H. Schrott (past) ; N. Olson (past) ; L. Snetselaar (past) ; R. Hoffman (past) ; J. MacIndoe (past) ; T. Weingeist (past) ; C. Fountain (past) ; S. Mendley ; S. Johnsonbaugh ; M. Patronas ; M. Carney ; P. Salemi (past) ; R. Liss (past) ; M. Hebdon (past) ; D. Counts (past) ; T. Donner (past) ; J. Gordon (past) ; R. Hemady (past) ; A. Kowarski (past) ; D. Ostrowski (past) ; S. Steidl (past) ; B. Jones (past) ; W.H. Herman ; C.L. Martin ; R. Pop-Busui ; D.A. Greene (past) ; M.J. Stevens (past) ; N. Burkhart (past) ; T. Sandford (past) ; J. Floyd (deceased) ; J. Bantle ; N. Wimmergren ; J. Terry ; D. Koozekanani ; S. Montezuma ; B. Rogness (past) ; M. Mech (past) ; T. Strand (past) ; J. Olson (past) ; L. McKenzie (past) ; C. Kwong (past) ; F. Goetz (past) ; R. Warhol (past) ; D. Hainsworth ; D. Goldstein ; S. Hitt ; J. Giangiacomo (deceased) ; D.S. Schade ; J.L. Canady ; M.R. Burge ; A. Das ; R.B. Avery ; L.H. Ketai ; J.E. Chapin ; M.L. Schluter (past) ; J. Rich (past) ; C. Johannes (past) ; D. Hornbeck (past) ; M. Schutta ; P.A. Bourne ; A. Brucker ; S. Braunstein (past) ; S. Schwartz (past) ; B.J. Maschak-Carey (past) ; L. Baker (deceased) ; T. Orchard ; L. Cimino ; T. Songer ; B. Doft ; S. Olson ; D. Becker ; D. Rubinstein ; R.L. Bergren ; J. Fruit ; R. Hyre ; C. Palmer ; N. Silvers (past) ; L. Lobes (past) ; P. Paczan Rath (past) ; P.W. Conrad (past) ; S. Yalamanchi (past) ; J.Wesche (past) ; M. Bratkowksi (past) ; S. Arslanian (past) ; J. Rinkoff (past) ; J. Warnicki (past) ; D. Curtin (past) ; D. Steinberg (past) ; G. Vagstad (past) ; R. Harris (past) ; L. Steranchak (past) ; J. Arch (past) ; K. Kelly (past) ; P. Ostrosaka (past) ; M. Guiliani (past) ; M. Good (past) ; T. Williams (past) ; K. Olsen (past) ; A. Campbell (past) ; C. Shipe (past) ; R. Conwit (past) ; D. Finegold (past) ; M. Zaucha (past) ; A. Drash (deceased) ; A. Morrison ; J.I. Malone ; M.L. Bernal ; P.R. Pavan ; N. Grove ; E.A. Tanaka (past) ; D. McMillan (past) ; J. Vaccaro-Kish (past) ; L. Babbione (past) ; H. Solc (past) ; T.J. DeClue (past) ; S. Dagogo-Jack ; C. Wigley ; H. Ricks ; A. Kitabchi ; E. Chaum ; M.B. Murphy (past) ; S. Moser (past) ; D. Meyer (past) ; A. Iannacone (past) ; S. Yoser (past) ; M. Bryer-Ash (past) ; S. Schussler (past) ; H. Lambeth (past) ; P. Raskin ; S. Strowig ; M. Basco (past) ; S. Cercone (deceased) ; B. Zinman ; A. Barnie ; R. Devenyi ; M. Mandelcorn ; M. Brent ; S. Rogers ; A. Gordon ; N. Bakshi ; B. Perkins ; L. Tuason ; F. Perdikaris ; R. Ehrlich (past) ; D. Daneman (past) ; K. Perlman (past) ; S. Ferguson (past) ; J. Palmer ; R. Fahlstrom ; I.H. de Boer ; J. Kinyoun ; L. Van Ottingham ; S. Catton (past) ; J. Ginsberg (past) ; C. McDonald ; J. Harth ; M. Driscoll ; T. Sheidow ; J. Mahon (past) ; C. Canny (past) ; D. Nicolle (past) ; P. Colby (past) ; J. Dupre (past) ; I. Hramiak (past) ; N.W. Rodger (past) ; M. Jenner (past) ; T. Smith (past) ; W. Brown (past) ; M. May ; J. Lipps Hagan ; A. Agarwal ; T. Adkins ; R. Lorenz (past) ; S. Feman (past) ; L. Survant (deceased) ; N.H. White ; L. Levandoski ; G. Grand ; M. Thomas ; D. Joseph ; K. Blinder ; G. Shah ; D. Burgess (past) ; I. Boniuk (deceased) ; J. Santiago (deceased) ; W. Tamborlane ; P. Gatcomb ; K. Stoessel ; P. Ramos ; K. Fong ; P. Ossorio ; J. Ahern (past) ; R. Gubitosi-Klug ; C. Beck ; S. Genuth ; J. Quin (past) ; P. Gaston (past) ; M. Palmert (past) ; R. Trail (past) ; W. Dahms (deceased) ; J. Lachin ; P. Cleary ; J. Backlund ; I. Bebu ; B. Braffett ; L. Diminick ; X. Gao ; W. Hsu ; K. Klumpp ; M. Larsen ; P. McGee (past) ; W. Sun (past) ; S. Villavicencio (past) ; K. Anderson (past) ; L. Dews (past) ; Naji Younes (past) ; B. Rutledge (past) ; K. Chan (past) ; D. Rosenberg (past) ; B. Petty (past) ; A. Determan (past) ; D. Kenny (past) ; C. Williams (deceased) ; C. Cowie ; C. Siebert (past) ; M. Steffes ; V. Arends ; J. Bucksa (past) ; M. Nowicki (past) ; B. Chavers (past) ; D. O&rsquo ; Leary ; J. Polak ; A. Harrington ; L. Funk (past) ; R. Crow (past) ; B. Gloeb (past) ; S. Thomas (past) ; C. O&rsquo ; Donnell (past) ; E.Z. Soliman ; Z.M. Zhang ; Y. Li ; C. Campbell ; L. Keasler ; S. Hensley ; J. Hu ; M. Barr ; T. Taylor ; R. Prineas (past) ; E.L. Feldman (past) ; J.W. Albers (past) ; P. Low (past) ; C. Sommer (past) ; K. Nickander (past) ; T. Speigelberg (past) ; M. Pfiefer (past) ; M. Schumer (past) ; M. Moran (past) ; J. Farquhar (past) ; C. Ryan (past) ; D. Sandstrom (past) ; T. Williams (past) ; M. Geckle (past) ; E. Cupelli (past) ; F. Thoma (past) ; B. Burzuk (past) ; T. Woodfill (past) ; R. Danis ; B. Blodi ; D. Lawrence ; H. Wabers ; S. Gangaputra (past) ; S. Neill (past) ; M. Burger (past) ; J. Dingledine (past) ; V. Gama (past) ; R. Sussman (past) ; M. Davis (past) ; L. Hubbard (past) ; M. Budoff ; S. Darabian ; P. Rezaeian ; N. Wong (past) ; M. Fox (past) ; R. Oudiz (past) ; L. Kim (past) ; R. Detrano (past) ; K. Cruickshanks ; D. Dalton ; K. Bainbridge ; J. Lima ; D. Bluemke ; E. Turkbey ; R.J. van der Geest (past) ; C. Liu (past) ; A. Malayeri (past) ; A. Jain (past) ; C. Miao (past) ; H. Chahal (past) ; R. Jarboe (past) ; D.M. Nathan ; V. Monnier ; D. Sell ; C. Strauch ; S. Hazen ; A. Pratt ; W. Tang ; J. Brunzell ; J. Purnell ; R. Natarajan ; F. Miao ; L. Zhang ; Z. Chen ; A. Paterson ; A. Boright ; S. Bull ; L. Sun ; S. Scherer (past) ; M. Lopes-Virella ; T.J. Lyons ; A. Jenkins ; R. Klein ; G. Virella ; A. Jaffa ; R. Carter ; J. Stoner ; W.T. Garvey (past) ; D. Lackland (past) ; M. Brabham (past) ; D. McGee (past) ; D. Zheng (past) ; R.K. Mayfield (past) ; J. Maynard (past) ; H. Wessells ; A. Sarma ; A. Jacobson ; R. Dunn ; S. Holt ; J. Hotaling ; C. Kim ; Q. Clemens ; J. Brown (past) ; K. McVary (past)
• 关键词：urinary tract infections ; diabetes mellitus ; risk factors
• 刊名：The Journal of Urology
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：196
• 期：4
• 页码：1129-1135
• 全文大小：472 K

文摘

We examined the relationship between glycemic control and urinary tract infections in women with type 1 diabetes mellitus.

Materials and Methods

Women enrolled in the Epidemiology of Diabetes Interventions and Complications study, the observational followup of the Diabetes Control and Complications Trial, were surveyed to assess the rate of physician diagnosed urinary tract infections in the preceding 12 months. The relationship between glycated hemoglobin levels and number of urinary tract infections in the previous 12 months was assessed using a multivariable Poisson regression model.

Results

A total of 572 women were evaluated at year 17. Mean age was 50.7 ± 7.2 years, mean body mass index was 28.6 ± 5.9 kg/m², mean type 1 diabetes duration was 29.8 ± 5.0 years and mean glycated hemoglobin was 8.0% ± 0.9%. Of these women 86 (15.0%) reported at least 1 physician diagnosed urinary tract infection during the last 12 months. Higher glycated hemoglobin levels were significantly associated with number of urinary tract infections such that for every unit increase (1%) in recent glycated hemoglobin level, there was a 21% (p=0.02) increase in urinary tract infection frequency in the previous 12 months after adjusting for race, hysterectomy status, urinary incontinence, sexual activity in the last 12 months, peripheral and autonomic neuropathy, and nephropathy.

Conclusions

The frequency of urinary tract infections increases with poor glycemic control in women with type 1 diabetes. This relationship is independent of other well described predictors of urinary tract infections and suggests that factors directly related to glycemic control may influence the risk of lower urinary tract infections.