Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Retina. 2012 Feb;32(2):322-9. doi: 10.1097/IAE.0b013e31821c4252.
To examine prevalence and associated factors of diabetic retinopathy in patients with Type 2 diabetes mellitus in urban communities of Beijing.
The community health care center-based study included subjects with diabetes mellitus and an age of 20 years to 80 years, who were recruited from 15 community health centers in urban Beijing. Diabetes mellitus was defined using the World Health Organization criteria. Fundus photographs were graded using the modified Airlie House classification system.
Of 2,642 eligible patients, 2,007 (76.0%) subjects (1,199 women) with a mean age of 64.1 ± 9.0 years participated. The overall prevalence of diabetic retinopathy was 24.7 ± 1.0% (95% confidence interval [CI], 22.8-26.6). In binary logistic analysis, presence of diabetic retinopathy was associated with younger age (odds ratio [OR], 0.97; 95% CI, 0.95-0.98), longer duration of diabetes (OR, 1.10; 95% CI, 1.08-1.12), higher concentration of glycosylated hemoglobin HbA1c (OR, 1.23; 95% CI, 1.14-1.33), higher systolic blood pressure (OR, 1.01; 95% CI, 1.01-1.02), lower body mass index (OR, 0.95; 95% CI, 0.92-0.98), and elevated blood urea concentration (OR, 1.01; 95% CI, 1.00-1.01). Microalbuminuria was an additional associated factor (OR, 1.55; 95% CI, 1.16-2.08). Patients with microalbuminuria were 4.7 times more likely to have a severe or proliferating diabetic retinopathy than those without microalbuminuria.
In the urban population of Beijing, prevalence of diabetic retinopathy in diabetic patients was 25%. As in whites, increased blood pressure besides elevated plasma glucose concentrations was highly significantly associated with diabetic retinopathy in Chinese. It suggests that in Chinese as also in whites, blood pressure control beside control of plasma glucose levels is important to prevent development or progression of diabetic retinopathy.
本研究旨在探讨北京市城区社区 2 型糖尿病患者中糖尿病视网膜病变的患病率及其相关因素。
本社区卫生服务中心为基础的研究纳入了年龄在 20 岁至 80 岁之间的糖尿病患者，这些患者来自北京市 15 个社区卫生服务中心。糖尿病的诊断标准采用世界卫生组织标准。眼底照片采用改良的 Airlie House 分类系统进行分级。
在 2642 名符合条件的患者中，有 2007 名（76.0%）患者（1199 名女性）参与了研究，平均年龄为 64.1±9.0 岁。糖尿病视网膜病变的总患病率为 24.7%±1.0%（95%置信区间，22.8%-26.6%）。在二元逻辑分析中，糖尿病视网膜病变的存在与年龄较小（比值比[OR]，0.97；95%置信区间，0.95-0.98）、糖尿病病程较长（OR，1.10；95%置信区间，1.08-1.12）、糖化血红蛋白 HbA1c 浓度较高（OR，1.23；95%置信区间，1.14-1.33）、收缩压较高（OR，1.01；95%置信区间，1.01-1.02）、体重指数较低（OR，0.95；95%置信区间，0.92-0.98）和血尿素浓度升高（OR，1.01；95%置信区间，1.00-1.01）有关。微量白蛋白尿也是一个相关因素（OR，1.55；95%置信区间，1.16-2.08）。微量白蛋白尿患者发生严重或增殖性糖尿病视网膜病变的可能性是无微量白蛋白尿患者的 4.7 倍。
在北京市城区人群中，糖尿病患者的糖尿病视网膜病变患病率为 25%。与白人一样，在中国人群中，除了升高的血糖浓度外，升高的血压也与糖尿病视网膜病变高度显著相关。这表明，在中国人群和白人中，控制血压除了控制血糖水平外，对于预防糖尿病视网膜病变的发生或进展也很重要。
