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糖尿病中的皮肤病和视网膜病变:它们之间有关联吗?

Dermopathy and retinopathy in diabetes: is there an association?

作者信息

Abdollahi Ali, Daneshpazhooh Maryam, Amirchaghmaghi Elham, Sheikhi Samira, Eshrati Babak, Bastanhagh Mohammad-Hassan

机构信息

Department of Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Dermatology. 2007;214(2):133-6. doi: 10.1159/000098572.

DOI:10.1159/000098572
PMID:17341862
Abstract

BACKGROUND/AIMS: Diabetic dermopathy is the most common cutaneous marker of diabetes mellitus presenting as single or multiple well-demarcated brown atrophic macules, predominantly on the shins. Although diabetic dermopathy and diabetic retinopathy are both considered by some authors as manifestations of diabetic microangiopathy, only a few studies are published about their possible association. Our purpose was to investigate the association of diabetic dermopathy and diabetic retinopathy.

METHODS

We conducted a cross-sectional study in an outpatient diabetes clinic during a 6-month period. One-hundred and eighty-one consecutive patients (8 cases of insulin-dependent diabetes mellitus and 173 cases of non-insulin-dependent diabetes mellitus) were examined for the presence of diabetic dermopathy and diabetic retinopathy.

RESULTS

Forty-seven (26%) showed diabetic dermopathy and 68 patients (37.6%) suffered from diabetic retinopathy. The frequency of retinopathy in patients with diabetic dermopathy (44%; 30 cases) was significantly greater than in patients without dermopathy (15%; 17 cases; p < 0.0001). Retinopathy showed a statistically significant association with dermopathy [odds ratio (OR): 3.60; 95% confidence interval (CI): 1.53-8.44; p = 0.003] and diabetes duration (OR: 3.36; 95% CI: 1.67-6.77; p = 0.001).

CONCLUSION

Our study further supports that diabetic dermopathy might be used as a telltale sign of diabetic retinopathy, necessitating more intensive ophthalmologic care, especially in long-lasting diabetes.

摘要

背景/目的:糖尿病性皮肤病是糖尿病最常见的皮肤表现,表现为单个或多个边界清晰的褐色萎缩性斑疹,主要位于小腿。尽管一些作者认为糖尿病性皮肤病和糖尿病视网膜病变均为糖尿病微血管病变的表现,但关于它们之间可能存在的关联,仅有少数研究发表。我们的目的是研究糖尿病性皮肤病与糖尿病视网膜病变之间的关联。

方法

我们在一家门诊糖尿病诊所进行了为期6个月的横断面研究。对181例连续就诊的患者(8例胰岛素依赖型糖尿病患者和173例非胰岛素依赖型糖尿病患者)进行了糖尿病性皮肤病和糖尿病视网膜病变检查。

结果

47例(26%)表现为糖尿病性皮肤病,68例患者(37.6%)患有糖尿病视网膜病变。患有糖尿病性皮肤病的患者中视网膜病变的发生率(44%;30例)显著高于无皮肤病的患者(15%;17例;p<0.0001)。视网膜病变与皮肤病[比值比(OR):3.60;95%置信区间(CI):1.53 - 8.44;p = 0.003]以及糖尿病病程(OR:3.36;95%CI:1.67 - 6.77;p = 0.001)之间存在统计学显著关联。

结论

我们的研究进一步支持糖尿病性皮肤病可能用作糖尿病视网膜病变的警示信号,这需要更强化的眼科护理,尤其是对于病程较长的糖尿病患者。

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