Pediatric Clinic, University of Genoa, IRCCS G. Gaslini Institute, Largo G. Gaslini 5, Genoa, Italy.
J Endocrinol Invest. 2012 Apr;35(4):389-94. doi: 10.3275/8016. Epub 2011 Oct 6.
Diabetic retinopathy seriously impairs patients' quality of life, since it represents the first cause of blindness in industrialized countries.
To estimate prevalence of retinopathy in young Type 1 diabetes patients using a non-mydriatic digital stereoscopic retinal imaging (NMDSRI), and to evaluate the impact of socio-demographic, clinical, and metabolic variables.
In 247 young patients glycated hemoglobin (HbA1c), gender, age, pubertal stage, presence of diabetic ketoacidosis (DKA), HLA-DQ heterodimers of susceptibility for Type 1 diabetes, and β-cell autoimmunity at clinical onset were considered. At retinopathy screening, we evaluated age, disease duration, pubertal stage, body mass index (BMI-SDS), insulin requirement, HbA1c levels, other autoimmune diseases, diabetes-related complications, serum concentrations of cholesterol and triglycerides, systolic and diastolic blood pressure.
Retinopathy was found in 26/247 patients: 25 showed background retinopathy, and 1 had a sight-threatening retinopathy. A significant relationship between retinopathy and female gender (p=0.01), duration of disease ≥15 yr (p<0.0001), serum triglycerides levels >65 mg/dl (p=0.012) and mean HbA1c ≥7.5% or >9% (p=0.0014) were found at the multivariate logistic analysis.
Metabolic control is the most important modifiable factor and promotion of continuous educational process to reach a good metabolic control is a cornerstone to prevent microangiopathic complications. Symptoms appear when the complication is already established; a screening program with an early diagnosis is mandatory to prevent an irreversible damage.
糖尿病视网膜病变严重影响患者的生活质量，因为它是工业化国家致盲的首要原因。
使用免散瞳数字立体视网膜成像（NMDSRI）评估年轻 1 型糖尿病患者视网膜病变的患病率，并评估社会人口统计学、临床和代谢变量的影响。
在 247 名年轻患者中，考虑糖化血红蛋白（HbA1c）、性别、年龄、青春期阶段、糖尿病酮症酸中毒（DKA）的存在、1 型糖尿病易感 HLA-DQ 异二聚体、以及临床发病时的β细胞自身免疫。在视网膜病变筛查时，我们评估了年龄、疾病持续时间、青春期阶段、体重指数（BMI-SDS）、胰岛素需求、HbA1c 水平、其他自身免疫性疾病、糖尿病相关并发症、胆固醇和甘油三酯血清浓度、收缩压和舒张压。
在 247 名患者中发现 26 名患有视网膜病变：25 名患有背景性视网膜病变，1 名患有威胁视力的视网膜病变。在多变量逻辑分析中发现，视网膜病变与女性性别（p=0.01）、疾病持续时间≥15 年（p<0.0001）、血清甘油三酯水平>65mg/dl（p=0.012）和平均 HbA1c≥7.5%或>9%（p=0.0014）之间存在显著关系。
代谢控制是最重要的可改变因素，促进持续的教育过程以达到良好的代谢控制是预防微血管并发症的基石。当并发症已经出现时症状才会出现；因此，必须进行早期诊断的筛查计划，以防止不可逆转的损害。
