Liu D P, Molyneaux L, Chua E, Wang Y Z, Wu C R, Jing H, Hu L N, Liu Y J, Xu Z R, Yue D K
Department of Endocrinology, Diabetes Centre, 306 Hospital of PLA, Beijing, PR China.
Diabetes Res Clin Pract. 2002 May;56(2):125-31. doi: 10.1016/s0168-8227(01)00349-7.
This study examined the prevalence of retinopathy in 2131 patients with type 2 diabetes attending a Beijing hospital for the first time. The median age of patients was 58 years (IQR 50-65). The overall prevalence of retinopathy was 27.3% (95% CI: 25.4-29.2) and for proliferative retinopathy 7.8% (95% CI: 6.7-8.9). When all patients were considered together, duration of diabetes (OR=1.8; P=0.001) and albumin excretion rate (OR=1.5; P=0.019) were independent risk factors for retinopathy. Blue-collar occupation (OR=1.5; P=0.047) and blood pressure (OR=1.2; P=0.021) were additional risk factors for non-proliferative and proliferative retinopathy respectively. Amongst the 773 newly diagnosed patients, 21% (95% CI: 17.8-23.6) already had retinopathy. The median age of those patients with retinopathy at diagnosis of diabetes was 3 years higher that those without retinopathy, and blue-collar workers (OR=2.2; P=0.012) as well as female gender were particularly at risk (OR=2.0; P=0.033). There was a strong correlation between duration of diabetes with the presence of retinopathy (r=0.95; P=0.01). By extrapolation, it could be estimated that some degree of hyperglycaemia might have been present for more than 20 years before diabetes was diagnosed. These findings emphasise the importance of earlier diagnosis of diabetes and its complications, especially in socially disadvantaged groups.
本研究调查了首次前往北京某医院就诊的2131例2型糖尿病患者的视网膜病变患病率。患者的中位年龄为58岁(四分位间距50 - 65岁)。视网膜病变的总体患病率为27.3%(95%置信区间:25.4 - 29.2),增殖性视网膜病变的患病率为7.8%(95%置信区间:6.7 - 8.9)。综合所有患者来看,糖尿病病程(比值比 = 1.8;P = 0.001)和白蛋白排泄率(比值比 = 1.5;P = 0.019)是视网膜病变的独立危险因素。蓝领职业(比值比 = 1.5;P = 0.047)和血压(比值比 = 1.2;P = 0.021)分别是非增殖性和增殖性视网膜病变的额外危险因素。在773例新诊断的患者中,21%(95%置信区间:17.8 - 23.6)已患有视网膜病变。糖尿病诊断时患有视网膜病变的患者的中位年龄比未患视网膜病变的患者高3岁,蓝领工人(比值比 = 2.2;P = 0.012)以及女性尤其易患(比值比 = 2.0;P = 0.033)。糖尿病病程与视网膜病变的存在之间存在强相关性(r = 0.95;P = 0.01)。据此推断,在糖尿病被诊断之前,某种程度的高血糖可能已经存在超过20年。这些发现强调了早期诊断糖尿病及其并发症的重要性,尤其是在社会弱势群体中。