Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Australia.
Invest Ophthalmol Vis Sci. 2011 Jun 22;52(7):4416-21. doi: 10.1167/iovs.11-7208.
To investigate the relationship between anthropometric parameters and diabetic retinopathy (DR) in adults with diabetes.
Five hundred participants with diabetes were recruited prospectively from ophthalmology clinics in Melbourne, Australia. Each underwent an eye examination, anthropometric measurements, and standardized interview-administered questionnaires, and fasting blood glucose and serum lipids were analyzed. Two-field fundus photographs were taken and graded for DR. Height; weight; body mass index (BMI); waist, hip, neck, and head circumferences; and skinfold measurements were recorded.
A total of 492 patients (325 men, 66.1%) aged between 26 and 90 years (median, 65) were included in the analysis: 171 (34.8%), 187 (38.0%), and 134 (27.2%) with no DR, nonproliferative DR (NPDR), and proliferative DR (PDR), respectively. After multiple adjustments, higher BMI (odds ratio [OR], 1.06; 95% confidence interval [CI],1.01-1.11; P = 0.02) was significantly associated with any DR. Obese people were 6.5 times more likely to have PDR than were those with normal weight (OR, 6.52; 95% CI, 1.49-28.6; P = 0.013). Neck circumference (OR, 1.05; 95% CI, 1.00-1.10; P = 0.03) and waist circumference (OR, 1.12; 95% CI, 1.03-1.22; P = 0.01) were significantly associated with any DR. BMI (OR, 1.04; 95% CI, 1.00-1.08; P = 0.04) and neck circumference (OR, 1.04 95% CI, 1.01-1.08; P = 0.04) were also positively associated with increasing severity levels of DR.
Persons with diabetes with higher BMI and larger neck circumference are more likely to have DR and more severe stages of DR. These data suggest that obesity is an independent risk factor for DR.
探讨成年人糖尿病患者的人体测量参数与糖尿病视网膜病变（DR）之间的关系。
前瞻性地从澳大利亚墨尔本的眼科诊所招募了 500 名糖尿病患者。每位患者均接受眼部检查、人体测量和标准化访谈问卷调查，并检测空腹血糖和血清脂质。拍摄并分级双眼视盘照片以诊断 DR。记录身高、体重、体重指数（BMI）、腰围、臀围、颈围和头围以及皮褶厚度。
共纳入 492 例年龄在 26 至 90 岁之间（中位数为 65 岁）的患者（325 名男性，66.1%）：分别有 171 例（34.8%）、187 例（38.0%）和 134 例（27.2%）无 DR、非增生性 DR（NPDR）和增生性 DR（PDR）。经过多次调整后，较高的 BMI（比值比 [OR]，1.06；95%置信区间 [CI]，1.01-1.11；P=0.02）与任何 DR 显著相关。肥胖患者发生 PDR 的可能性是体重正常患者的 6.5 倍（OR，6.52；95%CI，1.49-28.6；P=0.013）。颈围（OR，1.05；95%CI，1.00-1.10；P=0.03）和腰围（OR，1.12；95%CI，1.03-1.22；P=0.01）与任何 DR 显著相关。BMI（OR，1.04；95%CI，1.00-1.08；P=0.04）和颈围（OR，1.04；95%CI，1.01-1.08；P=0.04）与 DR 严重程度的增加也呈正相关。
BMI 较高和颈围较大的糖尿病患者更易发生 DR，且 DR 严重程度也更高。这些数据表明肥胖是 DR 的独立危险因素。
