El-Asrar A M, Al-Rubeaan K A, Al-Amro S A, Kangave D, Moharram O A
Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Int Ophthalmol. 1998;22(3):155-61. doi: 10.1023/a:1006240928938.
To describe the incidence of, and risk factors associated with, diabetic retinopathy in diabetic persons assessed at a Saudi diabetes centre.
Five hundred and two patients with diabetes mellitus assessed by our service were studied. There were 174 patients (34.7%) with insulin-dependent diabetes mellitus (IDDM) and 328 patients (65.3%) with non-insulin-dependent diabetes mellitus (NIDDM).
The incidence of retinopathy was 157/502 (31.3%). The incidence was 42.5% in patients with IDDM and 25.3% in those with NIDDM. By logistic regression analysis, it was shown that old age (>60 years), insulin use, long duration of diabetes (>10 years), poor diabetes control, and the presence of nephropathy were significantly associated with the incidence of retinopathy. On the basis of the magnitudes of the regression coefficients in the hazard function, long duration of diabetes was the most important independent risk factor for the development of retinopathy; the presence of nephropathy, age >60 years, poor diabetes control, and use of insulin were less important (regression coefficients: 1.9, 1.71, 1.331, 0.8508 and 0.6178, respectively). The incidence of macular oedema was significantly associated with the presence of hypertension and high cholesterol levels in patients with IDDM. Polycotomous regression analysis showed that the presence of nephropathy was the only factor significantly associated with the severity of retinopathy.
The significant associations with poor control and duration of diabetes provide further strong evidence for the benefits of optimal glycaemic control. Other potentially modifiable risk factors for retinopathy may be important, including elevated blood pressure and serum cholesterol.
描述在沙特糖尿病中心接受评估的糖尿病患者中糖尿病视网膜病变的发生率及相关危险因素。
对我们服务的502例糖尿病患者进行了研究。其中174例（34.7%）为胰岛素依赖型糖尿病（IDDM）患者，328例（65.3%）为非胰岛素依赖型糖尿病（NIDDM）患者。
视网膜病变的发生率为157/502（31.3%）。IDDM患者的发生率为42.5%，NIDDM患者为25.3%。通过逻辑回归分析表明，老年（>60岁）、使用胰岛素、糖尿病病程长（>10年）、糖尿病控制不佳以及存在肾病与视网膜病变的发生率显著相关。根据风险函数中回归系数的大小，糖尿病病程长是视网膜病变发生的最重要独立危险因素；存在肾病、年龄>60岁、糖尿病控制不佳和使用胰岛素的重要性相对较低（回归系数分别为：分别为1.9、1.71、1.331、0.8508和0.6178）。黄斑水肿的发生率与IDDM患者中高血压和高胆固醇水平的存在显著相关。多项回归分析表明，肾病的存在是与视网膜病变严重程度显著相关的唯一因素。
与糖尿病控制不佳和病程的显著关联为最佳血糖控制的益处提供了进一步有力证据。视网膜病变的其他潜在可改变危险因素可能也很重要，包括血压升高和血清胆固醇升高。
