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糖尿病和非糖尿病人群发生视网膜病变的危险因素:霍恩研究

Risk factors for incident retinopathy in a diabetic and nondiabetic population: the Hoorn study.

作者信息

van Leiden Hendrik A, Dekker Jacqueline M, Moll Annette C, Nijpels Giel, Heine Robert J, Bouter Lex M, Stehouwer Coen D A, Polak Bettine C P

机构信息

Department of Ophthalmology, VU University Medical Center, De Boelelaan 1117, 1007 MB Amsterdam, The Netherlands.

出版信息

Arch Ophthalmol. 2003 Feb;121(2):245-51. doi: 10.1001/archopht.121.2.245.

Abstract

OBJECTIVE

To investigate the effect of glycosylated hemoglobin, age, sex, hypertension, body mass index, waist-hip ratio, serum lipid levels, and smoking on the incidence of retinopathy in persons with normal and abnormal glucose metabolism.

METHODS

The incidence of retinopathy was determined in 233 individuals, aged 50 to 74 years, by ophthalmoscopy and fundus photography at baseline and after an average follow-up of 9.4 years. Relative risks for retinopathy, estimated by odds ratios, were calculated for tertiles of cardiovascular risk factors at baseline. Logistic regression analysis was used, without and with adjustment for age, sex, hypertension, and glucose metabolism.

RESULTS

The cumulative incidences of retinopathy among individuals with normal, impaired, and diabetic glucose metabolism were 7.3%, 13.6%, and 17.5%, respectively. Adjusted odds ratios for retinopathy were 2.36 (95% confidence interval, 1.02-5.49) for hypertension and 3.29 (95% confidence interval, 1.11-9.72) and 8.67 (95% confidence interval, 1.85-40.60) for the highest tertiles of glycosylated hemoglobin level and waist-hip ratio, respectively. No consistent or statistically significant associations with retinopathy were present for age, sex, body mass index, smoking, and serum levels of triglycerides and total, high-density lipoprotein, and non-high-density lipoprotein cholesterol (P>.05 for all).

CONCLUSION

Glycemia, hypertension, and abdominal obesity are determinants for retinopathy in a general population.

摘要

目的

研究糖化血红蛋白、年龄、性别、高血压、体重指数、腰臀比、血脂水平及吸烟对糖代谢正常和异常人群视网膜病变发生率的影响。

方法

通过眼底镜检查和眼底摄影,对233名年龄在50至74岁之间的个体在基线时及平均随访9.4年后的视网膜病变发生率进行测定。通过比值比估计视网膜病变的相对风险,并计算基线时心血管危险因素三分位数的相对风险。采用逻辑回归分析,分别在未调整及调整年龄、性别、高血压和糖代谢的情况下进行分析。

结果

糖代谢正常、受损及糖尿病个体中视网膜病变的累积发生率分别为7.3%、13.6%和17.5%。高血压患者视网膜病变的校正比值比为2.36(95%置信区间,1.02 - 5.49),糖化血红蛋白水平和腰臀比最高三分位数者的校正比值比分别为3.29(95%置信区间,1.11 - 9.72)和8.67(95%置信区间,1.85 - 40.60)。年龄、性别、体重指数、吸烟以及甘油三酯、总胆固醇、高密度脂蛋白胆固醇和非高密度脂蛋白胆固醇的血清水平与视网膜病变均无一致或具有统计学意义的关联(所有P>0.05)。

结论

血糖、高血压和腹型肥胖是普通人群视网膜病变的决定因素。

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