利用血红蛋白水平预测增殖性糖尿病视网膜病变
Prediction of proliferative diabetic retinopathy with hemoglobin level.
作者信息
Conway Baqiyyah N, Miller Rachel G, Klein Ronald, Orchard Trevor J
机构信息
University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA.
出版信息
Arch Ophthalmol. 2009 Nov;127(11):1494-9. doi: 10.1001/archophthalmol.2009.274.
OBJECTIVE
To investigate the role of hemoglobin (HGB) level in predicting proliferative diabetic retinopathy (PDR).
METHODS
We assessed 426 individuals without PDR at baseline (213 men; 213 women) from the Pittsburgh Epidemiology of Diabetes Complications Study, an 18-year prospective cohort study of childhood-onset type 1 diabetes. Presence of PDR was determined by stereo fundus photography. Cox proportional hazards modeling with stepwise regression was used to determine the independent association of HGB level with PDR. Analyses were sex specific.
RESULTS
There were 206 events. Although the incidence of PDR did not vary by sex (48% in both men and women), in men, HGB exhibited a positive linear relationship with 18-year incidence of PDR (hazard ratio, 1.33; 95% confidence interval, 1.10-1.60; P = .003), while in women, HGB level exhibited a quadratic relationship with PDR (P < .001). After multivariable adjustment for univariately significant covariates, HGB level remained significantly predictive of PDR in both men (P = .004) and women (P = .04).
CONCLUSION
Higher HGB level predicts the incidence of PDR in type 1 diabetes mellitus, though the association varies by sex, being linear and positive in men and quadratic in women.
目的
探讨血红蛋白（HGB）水平在预测增殖性糖尿病视网膜病变（PDR）中的作用。
方法
我们对匹兹堡糖尿病并发症流行病学研究中426例基线时无PDR的个体（213名男性；213名女性）进行了评估，该研究是一项针对儿童期发病的1型糖尿病的18年前瞻性队列研究。通过立体眼底摄影确定PDR的存在。采用逐步回归的Cox比例风险模型来确定HGB水平与PDR的独立关联。分析按性别进行。
结果
共发生206例事件。尽管PDR的发病率在性别上没有差异（男性和女性均为48%），但在男性中，HGB与PDR的18年发病率呈正线性关系（风险比，1.33；95%置信区间，1.10 - 1.60；P = 0.003），而在女性中，HGB水平与PDR呈二次关系（P < 0.001）。在对单变量有显著意义的协变量进行多变量调整后，HGB水平在男性（P = 0.004）和女性（P = 0.04）中仍然是PDR的显著预测指标。
结论
较高的HGB水平可预测1型糖尿病中PDR的发病率，尽管这种关联因性别而异，在男性中呈线性且为正相关，在女性中呈二次关系。
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