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高 HDL 胆固醇:糖尿病视网膜病变的危险因素?NO BLIND 研究结果。

High HDL cholesterol: A risk factor for diabetic retinopathy? Findings from NO BLIND study.

机构信息

University of Campania "Luigi Vanvitelli", Department of Advanced Medical and Surgical Sciences, Piazza Luigi Miraglia 2, 80138 Naples, Italy.

"Villa dei Fiori" Hospital, Corso Italia, 157, 80011 Acerra (Naples), Italy.

出版信息

Diabetes Res Clin Pract. 2019 Apr;150:236-244. doi: 10.1016/j.diabres.2019.03.028. Epub 2019 Mar 20.

Abstract

AIMS

To assess the correlation between diabetic retinopathy (DR) and potential risk factors, as well as the relationship between DR and the other complications of diabetes, in a real-life population of type 2 diabetes patients recruited in several centres in Italy.

METHODS

The NO BLIND is a cross-sectional, multicentre, observational study, which involved nine public outpatient clinics in Italy. The patients were assessed for eligibility from November 2016 till November 2017. Those enrolled underwent standard fundus oculi exam. Clinical and laboratory data were also collected.

RESULTS

2068 T2DM underwent fundus oculi exam. 435 received diagnosis of diabetic retinopathy (21%). Diabetic retinopathy was independently associated with HDL cholesterol (O.R.: 1.042; 95% C.I.: 1.012-1.109; p = 0.004), Albumin Excretion Rate (AER) (O.R.: 1.001; 95% C.I.: 1.000-1.002; p = 0.034) and GFR (O.R.: 1.159; 95% C.I.: 1.039-1.294; p = 0.008). HDL cholesterol values were hence split in two classes according to a potential cut-off (40 mg/dL), as defined by the ROC curve. Following analysis confirmed the association between DR and high HDL values (p = 0.032). Somatic neuropathy and diabetic ulcer were independently related with DR (p < 0.001 and p = 0.012, respectively).

CONCLUSIONS

A novel relationship between high HDL cholesterol and DR was observed.

摘要

目的

评估 2 型糖尿病患者的糖尿病视网膜病变(DR)与潜在危险因素之间的相关性,以及 DR 与糖尿病其他并发症之间的关系,该研究是在意大利几个中心招募的 2 型糖尿病患者的真实人群中进行的。

方法

NO BLIND 是一项横断面、多中心、观察性研究,涉及意大利的 9 个公共门诊。从 2016 年 11 月至 2017 年 11 月,对患者进行了资格评估。入选的患者接受了标准的眼底检查。还收集了临床和实验室数据。

结果

2068 例 T2DM 患者接受了眼底检查。435 例患者诊断为糖尿病视网膜病变(21%)。糖尿病视网膜病变与高密度脂蛋白胆固醇(OR:1.042;95%CI:1.012-1.109;p=0.004)、白蛋白排泄率(AER)(OR:1.001;95%CI:1.000-1.002;p=0.034)和肾小球滤过率(GFR)(OR:1.159;95%CI:1.039-1.294;p=0.008)独立相关。根据 ROC 曲线,将高密度脂蛋白胆固醇值分为两个可能的截断值(40mg/dL)。进一步的分析证实了 DR 与高 HDL 值之间的关联(p=0.032)。躯体神经病变和糖尿病溃疡与 DR 独立相关(p<0.001 和 p=0.012)。

结论

观察到高 HDL 胆固醇与 DR 之间存在新的关系。

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