Esteves Jorge F, Kramer Caroline K, Azevedo Mirela Jobim de, Stolz Andressa P, Roggia Murilo F, Larangeira Andréia, Miozzo Suellen A, Rosa Carolina, Lambert Jose Humberto, Pecis Miriam, Rodrigues Ticiana C, Canani Luis Henrique Santos
Hospital de Clinicas de Porto Alegre, Porto Alegre, Brasil.
Rev Assoc Med Bras (1992). 2009 May-Jun;55(3):268-73. doi: 10.1590/s0104-42302009000300017.
Diabetic retinopathy (DR) is the leading cause of legal blindness in young adults. Scarce data from Brazilian subjects with type 1 diabetes mellitus (DM) are available.
The objectives of this study were to determine the prevalence of DR and its risk factors in type 1 diabetes mellitus (DM) outpatients from a general hospital.
A cross-sectional study of 437 type 1 DM (50.3% males, 82.4% whites) was conducted. DR was graded as absent, mild and moderate non-proliferative DR (mild/moderate NPDR) or severe non-proliferative and proliferative DR (advanced DR). Presence of clinically significant macular edema (CSME) was also recorded.
Any DR was present in 44.4% of subjects. In multivariate analysis, DM duration, systolic blood pressure (SBP) and A1C test were associated with mild/moderate NPDR (P<0.005). Advanced DR, was associated with DM duration, SBP, smoking [odds ratio (OR) 2.75, 95%CI 1.15-6.60] and micro-or macroalbuminuria (OR 8.53, 95%CI 3.81-18.05). CSME was present in 21 (9.4%) patients and was associated with smoking (OR 3.19, 95%CI 1.24-8.2). Its frequency increased with the severity of DR (16.4% in advanced DR, 9.6% in mild/moderate NPDR, and 4.7% in the group without DR; P = 0.020).
Patients with type 1 DM attending an endocrine out-patient clinic at a general hospital had a high prevalence of DR associated with traditional risk-factors and smoking.
糖尿病视网膜病变（DR）是年轻成年人法定失明的主要原因。巴西1型糖尿病（DM）患者的相关数据稀缺。
本研究的目的是确定综合医院1型糖尿病（DM）门诊患者中DR的患病率及其危险因素。
对437例1型DM患者（50.3%为男性，82.4%为白人）进行了横断面研究。DR分为无、轻度和中度非增殖性DR（轻度/中度NPDR）或重度非增殖性和增殖性DR（晚期DR）。还记录了临床显著性黄斑水肿（CSME）的存在情况。
44.4%的受试者存在任何DR。在多变量分析中，DM病程、收缩压（SBP）和糖化血红蛋白（A1C）检测与轻度/中度NPDR相关（P<0.005）。晚期DR与DM病程、SBP、吸烟[比值比（OR）2.75，95%置信区间（CI）1.15 - 6.60]和微量或大量白蛋白尿（OR 8.53，95%CI 3.81 - 18.05）相关。21例（9.4%）患者存在CSME，且与吸烟相关（OR 3.19，95%CI 1.24 - 8.2）。其发生率随DR严重程度增加（晚期DR中为16.4%，轻度/中度NPDR中为9.6%，无DR组中为4.7%；P = 0.020）。
在综合医院内分泌门诊就诊的1型DM患者中，DR患病率较高，且与传统危险因素和吸烟相关。
