Department of Ophthalmology, The National University Hospital, Reykjavik, IcelandUniversity of Iceland, Reykjavik, IcelandDepartment of Ophthalmology, Örebro University Hospital, Örebro, SwedenDepartment of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology Section, Uppsala University, Uppsala, Sweden.
Acta Ophthalmol. 2014 Mar;92(2):133-7. doi: 10.1111/aos.12095. Epub 2013 Mar 4.
To evaluate the prevalence of and risk factors for, retinopathy in a geographically defined population with type 2 diabetes mellitus compared with a control group of subjects without diabetes, matched by age, sex and residence in order to find the retinopathy attributable to type 2 diabetes.
The study populations are, on one hand, a prevalence cohort of subjects with type 2 diabetes resident in the community of Laxå, Sweden, and on the other a control group, matched by age, gender and residence with those with a diagnosis of type 2 diabetes mellitus. Retinopathy was graded from fundus photographs using a modification of the Early Treatment Retinopathy Study (ETDRS) adaptation of the modified Airlie House classification of diabetic retinopathy (DR).
Any retinopathy was found in 34.6% in the type 2 diabetes cohort and in 8.8% in the control group without diabetes. Among the diabetic patients, any retinopathy was significantly associated with duration of diabetes (p = 0.0001), HbA1c (p = 0.0056), systolic blood pressure (p = 0.0091) and lower serum cholesterol (p = 0.0197) in multivariate logistic regression analyses. Having retinopathy in the control group was associated only with systolic blood pressure (p = 0.0014) in logistic regression analysis.
The prevalence of retinopathy among patients with type 2 diabetes in Laxå, Sweden, was similar or somewhat lower compared with other studies in the Nordic countries. The prevalence of retinopathy in a control group without diabetes equalled numbers from population studies worldwide. Our study indicates that the retinopathy that can be attributed to hyperglycaemia in the diabetic state is less common than is usually accounted for. A considerable fraction of retinopathy in subjects with diabetes may instead be due to other factors such as hypertension and should thus be treated correspondingly.
评估 2 型糖尿病患者的视网膜病变患病率和相关危险因素，并与无糖尿病的对照组相匹配，比较两组患者的年龄、性别和居住地，以发现归因于 2 型糖尿病的视网膜病变。
一方面，研究人群为居住在瑞典拉克萨社区的 2 型糖尿病患者的患病率队列；另一方面为对照组，与诊断为 2 型糖尿病的患者按年龄、性别和居住地相匹配。使用早期治疗糖尿病性视网膜病变研究（ETDRS）对糖尿病性视网膜病变（DR）改良 Airlie 屋分类法的改良版本对眼底照片进行分级。
在 2 型糖尿病队列中，34.6%的患者出现任何程度的视网膜病变，而在无糖尿病的对照组中，该比例为 8.8%。在糖尿病患者中，任何程度的视网膜病变均与糖尿病病程（p = 0.0001）、糖化血红蛋白（HbA1c）（p = 0.0056）、收缩压（p = 0.0091）和血清胆固醇水平较低（p = 0.0197）显著相关，在多变量逻辑回归分析中。在逻辑回归分析中，对照组出现视网膜病变仅与收缩压（p = 0.0014）相关。
与北欧其他国家的研究相比，瑞典拉克萨 2 型糖尿病患者的视网膜病变患病率相似或略低。无糖尿病对照组的视网膜病变患病率与全球人群研究的结果相当。我们的研究表明，糖尿病状态下可归因于高血糖的视网膜病变比通常认为的要少见。糖尿病患者的相当一部分视网膜病变可能归因于高血压等其他因素，因此应相应进行治疗。
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