非糖尿病个体的视网膜病变体征能否预测随后患糖尿病的风险？
Do retinopathy signs in non-diabetic individuals predict the subsequent risk of diabetes?
作者信息
Wong T Y, Mohamed Q, Klein R, Couper D J
机构信息
Retinal Vascular Imaging Centre, Centre for Eye Research Australia, Univeristy of Melbourne, 32 Gisborne Street, VIC 3002, Australia.
出版信息
Br J Ophthalmol. 2006 Mar;90(3):301-3. doi: 10.1136/bjo.2005.084400.
BACKGROUND/AIMS: Isolated retinopathy signs are common in non-diabetic individuals and have been shown to be associated with impaired glucose metabolism. In a cohort of people without diabetes, the association of these retinopathy signs and subsequent development of diabetes were examined.
METHODS
A population based cohort study of 7992 people aged 49-73 years without diabetes was conducted. Retinal photographs of these participants were evaluated for the presence of retinopathy signs according to a standardised protocol. Incident cases of diabetes were identified prospectively.
RESULTS
After a follow up of 3 years, 291 (3.6%) people developed incident diabetes. In the total cohort, retinopathy was not significantly associated with incident diabetes (4.7% v 3.6%, multivariable adjusted odds ratio (OR) 1.1, 95% confidence intervals (CI), 0.7 to 1.9). However, among participants with a positive family history of diabetes, retinopathy was associated with incident diabetes (10.4% v 4.8%, multivariable adjusted OR 2.3, 95% CI, 1.0 to 5.3). Among participants without a family history of diabetes, retinopathy was not associated with incident diabetes
CONCLUSIONS
In individuals with a family history of diabetes, retinopathy signs predict subsequent risk of clinical diabetes.
背景/目的：孤立性视网膜病变体征在非糖尿病个体中很常见，并且已被证明与糖代谢受损有关。在一组无糖尿病的人群中，研究了这些视网膜病变体征与糖尿病后续发生之间的关联。
方法
对7992名年龄在49 - 73岁之间的无糖尿病患者进行了一项基于人群的队列研究。根据标准化方案对这些参与者的视网膜照片进行评估，以确定是否存在视网膜病变体征。前瞻性地确定糖尿病的新发病例。
结果
经过3年的随访，291人（3.6%）发生了新发糖尿病。在整个队列中，视网膜病变与新发糖尿病无显著关联（4.7%对3.6%，多变量调整比值比（OR）为1.1，95%置信区间（CI）为0.7至1.9）。然而，在有糖尿病家族史的参与者中，视网膜病变与新发糖尿病有关（10.4%对4.8%，多变量调整OR为2.3，95%CI为1.0至5.3）。在无糖尿病家族史的参与者中，视网膜病变与新发糖尿病无关。
结论
在有糖尿病家族史的个体中，视网膜病变体征可预测后续临床糖尿病风险。
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