Chen Shih-Jen, Tung Tao-Hsin, Liu Jorn-Hon, Lee An-Fei, Lee Fenq-Lih, Hsu Wen-Ming, Chou Pesus
Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
Ophthalmic Epidemiol. 2008 Jan-Feb;15(1):2-9. doi: 10.1080/09286580701585736.
A community-based study was conducted to identify the extent of prevalence of refractive errors and their associated factors from among the Chinese type 2 diabetic population in Kinmen.
A total of 547 patients (> 40 years old) with type 2 diabetes were examined with a complete eye screening tests including objective autorefraction. Spherical equivalent refractions of right eyes were reported. Data collected include age, gender, general medical information and serum biochemistry.
The mean refraction was -0.83 +/- 2.49 D. Prevalence rates were determined for myopia (44.1%), hyperopia (24.1%), high myopia (13.0%), and astigmatism (87.8%). Age is an important factor for all of the refractive errors. After adjustment for age, male gender and > 3 grade nuclear opacity appeared to be statistically significant factors for myopia. For hyperopia, > or =7% HbA1c was a significant associated factor, and for astigmatism, > or =200 mg/dl total cholesterol was the risk factor. Multiple linear regression showed that every increase of one year of age and one percent of HbA1c is associated with 0.04 D (p = 0.003) and 0.13D (p = 0.04) shift in hyperopia, respectively. Nuclear opacity with grade 3-4 and grade 5-6 will shift toward myopia of -0.72D (p = 0.02) and -5.34D (p < 0.0001) after adjustment for other risk factors.
This study provides epidemiological data on refractive errors in a Chinese diabetic population in Kinmen, Taiwan. The myopia prevalence is higher than the reported rates in the general population. This survey further confirmed that myopia is more prevalent than hyperopia in the diabetic population. Age and blood sugar shift the refraction toward hyperopia while nuclear cataract reverses it. Correction of refractive errors in the diabetics remained a challenge as not only spectacles but medical intervention is mandatory.
开展一项基于社区的研究，以确定金门地区中国2型糖尿病患者屈光不正的患病率及其相关因素。
对总共547例年龄超过40岁的2型糖尿病患者进行了全面的眼部筛查检查，包括客观自动验光。报告了右眼的等效球镜度屈光不正情况。收集的数据包括年龄、性别、一般医疗信息和血清生化指标。
平均屈光不正度数为-0.83±2.49D。确定了近视（44.1%）、远视（24.1%）、高度近视（13.0%）和散光（87.8%）的患病率。年龄是所有屈光不正的一个重要因素。在调整年龄后，男性性别和核混浊程度>3级似乎是近视的统计学显著因素。对于远视，糖化血红蛋白（HbA1c）≥7%是一个显著的相关因素，而对于散光，总胆固醇≥200mg/dl是危险因素。多元线性回归显示，年龄每增加一岁和HbA1c每增加一个百分点，分别与远视度数增加0.04D（p = 0.003）和0.13D（p = 0.04）相关。在调整其他危险因素后，3-4级和5-6级核混浊将分别导致近视度数向-0.72D（p = 0.02）和-5.34D（p < 0.0001）转变。
本研究提供了台湾金门地区中国糖尿病患者屈光不正的流行病学数据。近视患病率高于一般人群的报告率。这项调查进一步证实，糖尿病患者中近视比远视更普遍。年龄和血糖会使屈光向远视方向转变，而核性白内障则使其逆转。糖尿病患者屈光不正的矫正仍然是一个挑战，因为不仅需要眼镜，而且医疗干预也是必不可少的。
