Department of Ophthalmology, St John's Medical College Hospital, Bangalore - 560 034, India.
Indian J Ophthalmol. 2011 May-Jun;59(3):207-10. doi: 10.4103/0301-4738.81029.
To assess the influence of urinary microalbuminuria and hemoglobin concentration on the occurrence and severity of diabetic retinopathy (DR), clinically significant macular edema (CSME) and hard exudate formation.
In this prospective cross-sectional study carried out over a period of 2 years, type 2 diabetic patients seeking ocular evaluation for DR were assessed for presence and severity of DR, presence of hard exudates and CSME. Retinal findings were correlated to severity of microalbuminuria, hemoglobin concentration and other systemic risk factors using linear regression analysis.
Three hundred and six patients were included in the study. DR of any grade was seen in 132 (43%) patients, hard exudate formation in 93/306 (30.4%) patients, CSME in 50/306 (16.3%) patients and proliferative DR in 26/306 (8.5%) patients. Duration of diabetes (P < 0.001), microalbuminuria (P < 0.001) and low hemoglobin (P = 0.001) were found to be highly significant risk factors for the development and increasing severity of DR as well as for CSME and hard exudate formation.
Microalbuminuria and low hemoglobin are strong predictors for DR, CSME and hard exudate formation in type 2 diabetics even after correcting for duration of diabetes and other systemic risk factors. Although not directly involved in the pathogenesis, microalbuminuria can help in identifying patients at risk for more severe diabetic eye disease. Microalbuminuria warrants intensive monitoring of both retinal and renal status. The hemoglobin levels should be monitored regularly in diabetic patients to detect and treat anemia, thereby reducing one risk factor for DR.
评估尿微量白蛋白和血红蛋白浓度对糖尿病视网膜病变（DR）的发生和严重程度、临床显著黄斑水肿（CSME）和硬性渗出物形成的影响。
在这项为期 2 年的前瞻性横断面研究中，对因 DR 而接受眼部评估的 2 型糖尿病患者评估了 DR 的存在和严重程度、硬性渗出物和 CSME 的存在。使用线性回归分析将视网膜发现与微量白蛋白尿、血红蛋白浓度和其他全身危险因素的严重程度相关联。
共纳入 306 例患者。132 例（43%）患者存在任何程度的 DR，93 例（30.4%）患者出现硬性渗出物形成，50 例（16.3%）患者出现 CSME，26 例（8.5%）患者出现增殖性 DR。糖尿病病程（P < 0.001）、微量白蛋白尿（P < 0.001）和低血红蛋白（P = 0.001）被发现是 DR 发展和严重程度增加以及 CSME 和硬性渗出物形成的高度显著危险因素。
即使在校正糖尿病病程和其他全身危险因素后，微量白蛋白尿和低血红蛋白也是 2 型糖尿病患者发生 DR、CSME 和硬性渗出物形成的有力预测因素。虽然微量白蛋白尿本身并不直接参与发病机制，但它可以帮助识别发生更严重糖尿病眼病的风险患者。微量白蛋白尿需要对视网膜和肾脏状况进行强化监测。应定期监测糖尿病患者的血红蛋白水平，以发现和治疗贫血，从而减少 DR 的一个危险因素。
