Abstract:Objective To investigate the factors affecting the development of non-proliferative diabetic retinopathy (NPDR) among patients with type 2 diabetic mellitus (T2DM), so as to provide insights into manangement of NPDR. Methods T2DM patients without obvious eye discomfort at ages of 18 years and older admitted to Department of Endocrinology, Jining No. 1 People's Hospital during the period from December 2019 to May 2021 were enrolled. Participants' demographics, smoking, alcohol consumption, medical history of diabetes and use of medicines were collected, and the height, weight and blood pressure were measured. The levels of glycosylated hemoglobin (HbA1c), fasting blood glucose, blood C-peptide, lipid and creatinine were tested, and retinopathy was examined with a non-mydriatic fundus camera. The factors affecting the development of NPDR were identified among T2DM patients using a multivariable logistic regression model. Results A total of 486 T2DM patients were enrolled, including 354 men (72.84%), with a median age of 48.00 (15.25) years, and median diabetes duration of 35.00 (104.25) months. The prevalence of NPDR was 19.34% among the participants. multivariable logistic regression analysis identified an educational level of senior high school and above (OR=0.546, 95%CI: 0.325-0.918), duration of diabetes (OR=1.008, 95%CI: 1.005-1.012), HbA1c (OR=1.183, 95%CI: 1.034-1.354) and use of non-sulfonylurea insulin secretagogues (OR=1.859, 95%CI: 1.082-3.196) as factors affecting the risk of NPDR among T2DM patients. Conclusion A high risk of NPDR is found among T2DM patients with a low educational level, long duration of diabetes, poor HbA1c control and use of non-sulfonylurea insulin secretagogues.
姜佳佳, 李峰, 房冬冬, 尤文君, 王伟伟. 2型糖尿病患者非增殖型糖尿病性视网膜病变的影响因素分析[J]. 预防医学, 2023, 35(1): 17-20.
JIANG Jiajia, LI Feng, FANG Dongdong, YOU Wenjun, WANG Weiwei. Factors affecting the risk of non-proliferative diabetic retinopathy among patients with type 2 diabetic mellitus. Preventive Medicine, 2023, 35(1): 17-20.
[1] CHEUNG N,MITCHELL P,WONG T.Diabetic retinopathy[J].Lancet,2010,376(9735):124-136. [2] WONG T Y,CHEUNG C M G,LARSEN M,et al.Diabetic retinopathy[J/OL].Nat Rev Dis Primers,2016,2[2022-11-29].http://dx.doi.org/10.1038/nrdp.2016.12. [3] 邓宇轩,叶雯青,孙艳婷,等.中国糖尿病视网膜病变患病率的荟萃分析[J].中华医学杂志,2020,100(48):3846-3852. [4] LIN K Y,HSIH W H,LIN Y B,et al.Update in the epidemiology,risk factors,screening,and treatment of diabetic retinopathy[J].J Diabetes Investig,2021,12(8):1322-1325. [5] LI W,WANG A P,JIANG J J,et al.Risk of chronic kidney disease defined by decreased estimated glomerular filtration rate in individuals with different prediabetic phenotypes:results from a prospective cohort study in China[J/OL].BMJ Open Diabetes Res Care,2020,8(1)[2022-11-29].http://dx.doi.org/10.1136/bmjdrc-2019-000955. [6] 李淑婷,王相宁,吴强.糖尿病视网膜病变筛查意义及操作指南[J].中华眼底病杂志,2019,35(2):200-206. [7] 《中国高血压防治指南》修订委员会.中国高血压防治指南(2018年修订版)[J].心脑血管病防治,2019,19(1):1-44. [8] 诸骏仁,高润霖,赵水平,等.中国成人血脂异常防治指南(2016年修订版)[J].中华健康管理学杂志,2017,11(1):7-28. [9] VUJOSEVIC S,ALDINGTON S J,SILVA P,et al.Screening for diabetic retinopathy:new perspectives and challenges[J].Lancet Diabetes Endocrinol,2020,8(4):337-347. [10] SAEEDI P,PETERSOHN I,SALPEA P,et al.Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045:results from the International Diabetes Federation Diabetes Atlas,9th edition[J/OL].Diabetes Res Clin Pract,2019,157[2022-11-29].https://doi.org/10.1016/j.diabres.2019.107843. [11] SONG P,YU J,CHAN K,et al.Prevalence,risk factors and burden of diabetic retinopathy in China:a systematic review and meta-analysis[J/OL].J Glob Health,2018,8(1)[2022-11-29].http://dx.doi.org/10.7189/jogh.08.010803. [12] 肖子轩,白桂荣,贺艳婷,等.宁夏部分社区2型糖尿病视网膜病变患病率及影响因素[J].社区医学杂志,2021,19(8):475-479. [13] 刘金纪,王欢,龙陟罡,等.柳州市糖尿病患者视网膜病变的患病率调查及其影响因素[J].中华疾病控制杂志,2021,25(6):673-678. [14] 江旭. 3 404例2型糖尿病患者视网膜病变患病率及其相关因素分析[D].合肥:安徽医科大学,2020. [15] 孙娟,何红.糖尿病视网膜病变危险因素的研究进展[J].中华眼底病杂志,2020,36(12):986-990. [16] KAWASAKI R,TANAKA S,TANAKA T,et al.Incidence and progression of diabetic retinopathy in Japanese adults with type 2 diabetes:8 year follow-up study of the Japan Diabetes Complications Study(JDCS)[J].Diabetologia,2011,54(9):2288-2294. [17] CUI Y,ZHANG M,ZHANG L,et al.Prevalence and risk factors for diabetic retinopathy in a cross-sectional population-based study from rural southern China:Dongguan Eye Study[J/OL].BMJ Open,2019,9(9)[2022-11-29].http://dx.doi.org/10.1136/bmjopen-2018-023586. [18] 李娜,杨秀芬,邓禹,等.2型糖尿病患者自我管理水平与糖尿病视网膜病变的相关性研究[J].中华眼科杂志,2013,49(6):500-506. [19] 吴敏,李峰,姜佳佳.2型糖尿病患者受教育程度与非增殖性糖尿病视网膜病变相关性研究[J].现代医药卫生,2022,38(13):2283-2287. [20] 何雅薇,葛华英,李修英,等.中青年2型糖尿病患者自我管理行为的影响因素研究[J].预防医学,2022,34(3):258-262. [21] 路春. 餐后血糖与糖尿病视网膜病变发病的关系[J].上海医药,2017,38(24):36-38. [22] 蒋双双,陈小鸟,董哲毅,等.糖尿病视网膜病变与糖尿病肾病的相关性及其诊断价值研究进展[J].解放军医学杂志,2021,46(1):64-70.