Department of Ophthalmology and Neurosurgery, University Hospital of North Norway, Tromsø, NorwayResearch Group of Epidemiology of Chronic Diseases, Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, NorwayNIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UKDepartment of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, NorwayDepartment of Nephrology, University Hospital of North Norway, Tromsø, NorwayDepartment of Clinical Medicine, University of Tromsø, Tromsø, NorwayDepartment of Ophthalmology, Odense University Hospital, Odense, DenmarkBrain and Circulation Research Group, Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway.
Acta Ophthalmol. 2013 Dec;91(8):716-21. doi: 10.1111/j.1755-3768.2012.02542.x. Epub 2012 Sep 20.
To determine the prevalence of visual impairment, retinopathy and macular oedema, and assess risk factors for retinopathy in persons with diabetes.
The present study included 514 participants with diabetes aged 46-87 years from the Tromsø Eye Study, a sub-study of the population-based Tromsø Study in Norway. Visual acuity was measured using an auto-refractor. Retinal images from both eyes were graded for retinopathy and macular oedema. We collected data on risk factor exposure from self-report questionnaires, clinical examinations, laboratory measurements and case note reviews. Regression models assessed the cross-sectional relationship between potential risk factors and diabetic retinopathy.
The prevalence of visual impairment (corrected Snellen visual acuity <20/60 in the better-seeing eye) was 1.6%. The prevalence of diabetic retinopathy was 26.8% and macular oedema 3.9%. In a multivariable logistic regression model, retinopathy was associated with longer diabetes duration (odds ratio, OR 1.07, 95% CI 1.03-1.11), insulin use (OR 2.14, 95% CI 1.19-3.85), nonfasting glucose (OR 1.07, 95% CI 1.00-1.15) and microalbuminuria (OR 1.89, 95% CI 1.28-2.81). Sub-group analyses showed association between retinopathy and even low levels of microalbuminuria (1.16 mg/mmol).
The findings suggest that low levels of microalbuminuria may be a useful risk predictor for identifying individuals with diabetes at high risk of retinopathy. The study confirms previous findings that insulin use, longer diabetes duration and higher levels of blood glucose are associated with retinopathy in persons with diabetes. The prevalence of diabetic retinopathy was similar as reported in other studies.
确定视力障碍、视网膜病变和黄斑水肿的患病率，并评估糖尿病患者视网膜病变的危险因素。
本研究纳入了来自挪威特罗姆瑟研究人群基础特罗姆瑟研究子研究的 514 名年龄在 46-87 岁的糖尿病患者。使用自动折射仪测量视力。对双眼视网膜图像进行分级，以评估视网膜病变和黄斑水肿。我们从自我报告问卷、临床检查、实验室测量和病历回顾中收集了危险因素暴露的数据。回归模型评估了潜在危险因素与糖尿病视网膜病变之间的横断面关系。
视力障碍（较好眼矫正 Snellen 视力<20/60）的患病率为 1.6%。糖尿病视网膜病变的患病率为 26.8%，黄斑水肿的患病率为 3.9%。在多变量逻辑回归模型中，视网膜病变与糖尿病病程较长（比值比，OR 1.07，95%可信区间 1.03-1.11）、使用胰岛素（OR 2.14，95%可信区间 1.19-3.85）、非空腹血糖（OR 1.07，95%可信区间 1.00-1.15）和微量白蛋白尿（OR 1.89，95%可信区间 1.28-2.81）有关。亚组分析显示，即使微量白蛋白尿水平较低，也与视网膜病变有关（1.16mg/mmol）。
研究结果表明，低水平的微量白蛋白尿可能是识别糖尿病患者发生视网膜病变风险较高的有用危险因素。该研究证实了先前的发现，即胰岛素使用、糖尿病病程较长和血糖水平较高与糖尿病患者的视网膜病变有关。糖尿病视网膜病变的患病率与其他研究报告的相似。
