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糖尿病视网膜病变的患病率及相关因素。2006年北京眼病研究

Prevalence and associated factors of diabetic retinopathy. The Beijing Eye Study 2006.

作者信息

Xie Xi Wei, Xu Liang, Wang Ya Xing, Jonas Jost B

机构信息

Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, 17 Hougou Street, Chong Wen Men, 100005, Beijing, China.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2008 Nov;246(11):1519-26. doi: 10.1007/s00417-008-0884-6. Epub 2008 Jul 5.

Abstract

BACKGROUND

To evaluate the prevalence and associated factors of diabetic retinopathy in adult Chinese with diabetes mellitus.

METHODS

The Beijing Eye Study 2006 is a population-based cross-sectional study that included 3,251 (73.2%) subjects (aged 45+ years) out of 4,439 subjects originally participating in the Beijing Eye Study 2001. Diabetes defined as fasting glucose concentrations > or = 7.0 mmol/L or self-reported diagnosis of diabetes was detected in 381/3,251 (12.9%) subjects. Diabetic retinopathy was defined by the presence of at least one microaneurysm in the diabetic subjects according to the Early Treatment of Diabetic Retinopathy Study (ETDRS).

RESULTS

Gradable fundus photographs were available for 362 (95.0%) subjects. Diabetic retinopathy was detected in 101 subjects (27.9%). Most of the diabetic retinopathy was of the mild type (74/101; 73%). Severe non-proliferative or proliferative diabetic retinopathy was present in 16 (16%) subjects, and clinically significant macular edema in four (4%) subjects. Presence of diabetic retinopathy was significantly associated with rural region (Odds ratio (OR): 3.52), duration of diabetes mellitus (OR: 1.08), fasting plasma glucose concentration (OR: 1.14), type of diabetes treatment (OR: 2.09), and marginally significantly, with hyperopic refractive error (OR: 1.13; P = 0.08). The stage of diabetic retinopathy was associated with rural region (P < 0.001), known duration of diabetes (P = 0.001), type of diabetes treatment (P = 0.001), concentrations of high-density lipoproteins (P = 0.004), and fasting glucose concentrations (P = 0.002).

CONCLUSIONS

Prevalence of diabetic retinopathy among adult diabetic Chinese was about 27.9%. The stage of retinopathy was mild in 75% of the subjects with diabetic retinopathy. Associated factors were diabetes duration, diabetic treatment type, low metabolic control, rural region, and marginally hyperopia.

摘要

背景

评估中国成年糖尿病患者糖尿病视网膜病变的患病率及相关因素。

方法

2006年北京眼病研究是一项基于人群的横断面研究,最初参与2001年北京眼病研究的4439名受试者中有3251名(73.2%)年龄在45岁及以上的受试者纳入本研究。在3251名受试者中,381名(12.9%)被检测出患有糖尿病,糖尿病定义为空腹血糖浓度≥7.0 mmol/L或自我报告患有糖尿病。根据糖尿病视网膜病变早期治疗研究(ETDRS),糖尿病患者中至少存在一个微动脉瘤则定义为糖尿病视网膜病变。

结果

362名(95.0%)受试者可获得可分级的眼底照片。101名受试者(27.9%)被检测出患有糖尿病视网膜病变。大多数糖尿病视网膜病变为轻度(74/101;73%)。16名(16%)受试者存在重度非增殖性或增殖性糖尿病视网膜病变,4名(4%)受试者存在临床显著性黄斑水肿。糖尿病视网膜病变的存在与农村地区(比值比(OR):3.52)、糖尿病病程(OR:1.08)、空腹血糖浓度(OR:1.14)、糖尿病治疗类型(OR:2.09)显著相关,与远视屈光不正有边缘性显著关联(OR:1.13;P = 0.08)。糖尿病视网膜病变的分期与农村地区(P < 0.001)、已知糖尿病病程(P = 0.001)、糖尿病治疗类型(P = 0.001)、高密度脂蛋白浓度(P = 0.004)和空腹血糖浓度(P = 0.002)相关。

结论

中国成年糖尿病患者中糖尿病视网膜病变的患病率约为27.9%。75%患有糖尿病视网膜病变的受试者视网膜病变分期为轻度。相关因素包括糖尿病病程、糖尿病治疗类型、代谢控制不佳、农村地区以及边缘性远视。

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