Pedro Romero-Aroca, Ramon Sagarra-Alamo, Marc Baget-Bernaldiz, Juan Fernández-Ballart, Isabel Méndez-Marin
Ophthalmic Service, Hospital Universitario Sant Joan, Universidad Rovira I Virgili, Reus, Spain.
Ophthalmic Epidemiol. 2010 Aug;17(4):251-65. doi: 10.3109/09286586.2010.498661.
To determine the prevalence of microangiopathy, and its risk factors in a population-based study of diabetes mellitus patients in the north-eastern area of Spain.
A population-based transversal study of 8,187 type 2 (83.37% of the diagnosed patients) and 488 type 1 (85.76% of the diagnosed patients) underwent a detailed medical history that included: diagnoses of diabetic retinopathy, macular edema, microalbuminuria or overt nephropathy. A study of its risk factors, and the relationship between diabetic retinopathy and renal lesion was performed.
In type 1 diabetes patients we observed a prevalence of 36.47% of diabetic retinopathy and 5.73% with macular edema; in type 2 diabetes patients the prevalence of diabetic retinopathy was 26.11% and 6.44% with macular edema. Microalbuminuria prevalence was 25.61% in type 1 and 17.78% in type 2 patients, and overt nephropathy prevalence was 8.60% in type 1 and 6.74% in type 2 diabetic patients. The risk factors for diabetic retinopathy were: diabetes duration, high glycosylated level, and arterial hypertension, and insulin treatment in type 2. The Total-cholesterol/High Density-cholesterol (TC/HDL) ratio and triglycerides were significant for diabetic macular edema (DME). Microalbuminuria and overt nephropathy were well correlated to diabetes duration, arterial hypertension and glycosylated haemoglobin.
Prevalence and risk factors for microangiopathy are similar to other studies, and the important finding is that the TC/HDL ratio was significant for DME. Microalbuminuria is a risk factor for diabetic retinopathy in type 1 diabetes mellitus patients but not for type 2. Overt nephropathy is well correlated with diabetic retinopathy.
在西班牙东北部地区开展的一项针对糖尿病患者的基于人群的研究中,确定微血管病变的患病率及其危险因素。
一项基于人群的横断面研究,对8187例2型糖尿病患者(占确诊患者的83.37%)和488例1型糖尿病患者(占确诊患者的85.76%)进行了详细的病史调查,包括:糖尿病视网膜病变、黄斑水肿、微量白蛋白尿或显性肾病的诊断。对其危险因素以及糖尿病视网膜病变与肾脏病变之间的关系进行了研究。
在1型糖尿病患者中,我们观察到糖尿病视网膜病变的患病率为36.47%,黄斑水肿的患病率为5.73%;在2型糖尿病患者中,糖尿病视网膜病变的患病率为26.11%,黄斑水肿的患病率为6.44%。1型患者微量白蛋白尿患病率为25.61%,2型患者为17.78%,1型糖尿病患者显性肾病患病率为8.60%,2型糖尿病患者为6.74%。糖尿病视网膜病变的危险因素为:糖尿病病程、高糖化水平、动脉高血压以及2型糖尿病患者的胰岛素治疗。总胆固醇/高密度脂蛋白(TC/HDL)比值和甘油三酯对糖尿病黄斑水肿(DME)具有显著意义。微量白蛋白尿和显性肾病与糖尿病病程、动脉高血压和糖化血红蛋白密切相关。
微血管病变的患病率和危险因素与其他研究相似,重要的发现是TC/HDL比值对DME具有显著意义。微量白蛋白尿是1型糖尿病患者糖尿病视网膜病变的危险因素,但不是2型糖尿病患者的危险因素。显性肾病与糖尿病视网膜病变密切相关。