血清脂质对有临床意义与无临床意义的黄斑水肿的影响：SN-DREAMS 报告第 13 号。

Influence of serum lipids on clinically significant versus nonclinically significant macular edema: SN-DREAMS Report number 13.

机构信息

Shri Bhagwan Mahavir Vitreoretinal Services, Tamil Nadu, India.

出版信息

Ophthalmology. 2010 Apr;117(4):766-72. doi: 10.1016/j.ophtha.2009.09.005. Epub 2010 Jan 4.

DOI:10.1016/j.ophtha.2009.09.005

PMID:20045565

Abstract

PURPOSE

To estimate the prevalence of diabetic macular edema, both clinically significant macular edema (CSME) and nonclinically significant macular edema (non-CSME), and report the associations of dyslipidemia on them.

DESIGN

A population-based cross-sectional study in India.

PARTICIPANTS

After all exclusions, 1414 subjects with diabetes underwent an examination.

METHODS

The CSME was defined according to the Early Treatment Diabetic Retinopathy Study (ETDRS) guidelines; stereo digital fundus pairs were studied. The dyslipidemia cases were classified according to the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III).

MAIN OUTCOME MEASURES

Prevalence of CSME and non-CSME and association of serum lipids with them.

RESULTS

The prevalence was 31.76% (95% confidence interval [CI], 26.04-37.47) for overall diabetic macular edema, 25.49% (95% Ci, 20.14-30.84) for non-CSME, and 6.27% (95% Ci, 3.29-9.24) for CSME. Univariate analysis identified macroalbuminuria and microalbuminuria, poor glycemic control, high total serum cholesterol, high serum low-density lipoprotein (LDL) cholesterol, and high serum non-high-density lipoprotein (HDL) cholesterol related to non-CSME and CSME (trend chi-square test, P<0.05). Logistic regression analysis (after adjusting variables such as age, gender, body mass index, duration, smoking, hypertension, glycosylated hemoglobin, macroalbuminuria and microalbuminuria, and insulin use) revealed high serum LDL cholesterol (odds ratio [OR], 2.72], high serum non-HDL cholesterol (OR, 1.99), and high cholesterol ratio (OR, 3.08) related to non-CSME, and poor glycemic control (OR, 8.06), microalbuminuria (OR, 14.23), and high serum total cholesterol (OR, 9.09) related to CSME.

CONCLUSIONS

One third of the subjects had diabetic macular edema, and 6% of them showed evidence of CSME necessitating laser photocoagulation.

FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

摘要

目的

评估糖尿病性黄斑水肿（包括临床显著黄斑水肿[CSME]和非临床显著黄斑水肿[non-CSME]）的患病率，并报告血脂异常与之的相关性。

设计

印度的一项基于人群的横断面研究。

参与者

排除所有禁忌症后，共有 1414 名糖尿病患者接受了检查。

方法

根据早期治疗糖尿病性视网膜病变研究（ETDRS）指南定义 CSME；研究立体数字眼底对。根据国家胆固醇教育计划-成人治疗小组 III（NCEP-ATP III）对血脂异常病例进行分类。

主要观察指标

CSME 和 non-CSME 的患病率以及血清脂质与它们的相关性。

结果

总体糖尿病性黄斑水肿的患病率为 31.76%（95%置信区间[CI]，26.04%-37.47%），non-CSME 的患病率为 25.49%（95%CI，20.14%-30.84%），CSME 的患病率为 6.27%（95%CI，3.29%-9.24%）。单变量分析发现，macroalbuminuria 和 microalbuminuria、血糖控制不佳、总血清胆固醇高、血清低密度脂蛋白（LDL）胆固醇高、血清非高密度脂蛋白（HDL）胆固醇高与 non-CSME 和 CSME 相关（趋势卡方检验，P<0.05）。逻辑回归分析（在调整年龄、性别、体重指数、病程、吸烟、高血压、糖化血红蛋白、macroalbuminuria 和 microalbuminuria、胰岛素使用等变量后）显示，高血清 LDL 胆固醇（比值比[OR]，2.72）、高血清非 HDL 胆固醇（OR，1.99）和高胆固醇比值（OR，3.08）与 non-CSME 相关，血糖控制不佳（OR，8.06）、microalbuminuria（OR，14.23）和高血清总胆固醇（OR，9.09）与 CSME 相关。