糖尿病视网膜病变是缺血性卒中的独立危险因素吗？

Is diabetic retinopathy an independent risk factor for ischemic stroke?

作者信息

Cheung Ning, Rogers Sophie, Couper David J, Klein Ronald, Sharrett A Richey, Wong Tien Y

机构信息

Centre for Eye Research Australia, University of Melbourne, 32 Gisborne Street, Victoria 3002, Australia.

出版信息

Stroke. 2007 Feb;38(2):398-401. doi: 10.1161/01.STR.0000254547.91276.50. Epub 2006 Dec 28.

DOI:10.1161/01.STR.0000254547.91276.50

PMID:17194880

Abstract

BACKGROUND AND PURPOSE

The relationship between diabetic retinopathy and ischemic stroke is uncertain and examined in this study.

METHODS

A population-based, prospective cohort study of 1617 middle-aged persons with diabetes. Diabetic retinopathy signs were ascertained from retinal photographs, and incident ischemic stroke events were prospectively identified and validated.

RESULTS

Over an average follow-up of 7.8 years, there were 75 ischemic stroke events. After adjustment for age, gender, race, center, 6-year mean arterial blood pressure, anti-hypertensive treatment use, fasting glucose, insulin treatment, duration of diabetes, high-density lipoprotein and low-density lipoprotein cholesterol levels and cigarette smoking status, diabetic retinopathy was associated with an increased risk of ischemic stroke (hazard rate ratio, 2.34; 95% CI, 1.13 to 4.86).

CONCLUSIONS

Diabetic retinopathy predicts incident ischemic stroke in people with diabetes, independent of other risk factors.

摘要

背景与目的

本研究探讨糖尿病视网膜病变与缺血性卒中之间的关系，该关系尚不明确。

方法

对1617名中年糖尿病患者进行基于人群的前瞻性队列研究。通过视网膜照片确定糖尿病视网膜病变体征，并前瞻性地识别和验证缺血性卒中事件。

结果

平均随访7.8年期间，发生75例缺血性卒中事件。在调整年龄、性别、种族、中心、6年平均动脉血压、抗高血压治疗使用情况、空腹血糖、胰岛素治疗、糖尿病病程、高密度脂蛋白和低密度脂蛋白胆固醇水平以及吸烟状况后，糖尿病视网膜病变与缺血性卒中风险增加相关（风险率比为2.34；95%可信区间为1.13至4.86）。