Akhter Afroza, Fatema Kaniz, Ahmed Sayed Foysal, Afroz Afsana, Ali Liaquat, Hussain Akhtar
Department of Epidemiology, Bangladesh Institute of Health Sciences (BIHS), Dhaka, Bangladesh.
Ophthalmic Epidemiol. 2013 Aug;20(4):220-7. doi: 10.3109/09286586.2013.809770.
To determine the prevalence of retinopathy among people with normal and abnormal glucose metabolism in a remote rural community of Bangladesh, and to identify the associated risk indicators for developing retinopathy in this population.
A population-based cross-sectional study was conducted through screening in camp settings, which included a total of 836 participants (468 male and 368 female) aged 30 years or over. Retinopathy was determined by fundus photography. Anthropometric measures (body mass index and waist-to-hip ratio), oral glucose tolerance, glycosylated hemoglobin (HbA1c), blood pressure, lipid profile, serum creatinine and urine albumin creatinine ratio (UACR) were measured. Logistic regression analysis was used with adjustment for potential confounders.
The overall prevalence of retinopathy was 5.4% (95% confidence interval, CI, 3.9-6.9). The prevalence rates of retinopathy among diabetic, impaired glucose regulation and non-diabetic subjects were 21.6%, 13% and 3.5%, respectively. Adjusted odds ratios for retinopathy were 2.53 (95% CI 1.52-5.41) for abnormal glucose metabolism and 1.98 (95% CI 1.17-5.63), 1.74 (95% CI 1.09-3.02) and 1.63 (95% CI 1.08-3.12) for hypertension, HbA1c and UACR, respectively. Additionally, age, body mass index, triglyceride and total cholesterol were also found to be significant independent risk indicators for the occurrence of retinopathy in this population.
A high prevalence of retinopathy was observed in this rural Bangladeshi population. In addition to blood glucose control for diabetes, screening for hypertension, obesity, hyperlipidemia and proteinuria as well as adequate treatment of these risk indicators may prevent retinopathy in rural Bangladeshi populations.
确定孟加拉国一个偏远农村社区中葡萄糖代谢正常和异常人群的视网膜病变患病率，并确定该人群发生视网膜病变的相关风险指标。
通过在营地环境中进行筛查开展一项基于人群的横断面研究，共纳入836名年龄在30岁及以上的参与者（468名男性和368名女性）。通过眼底摄影确定视网膜病变情况。测量人体测量指标（体重指数和腰臀比）、口服葡萄糖耐量、糖化血红蛋白（HbA1c）、血压、血脂谱、血清肌酐和尿白蛋白肌酐比值（UACR）。采用逻辑回归分析并对潜在混杂因素进行校正。
视网膜病变的总体患病率为5.4%（95%置信区间，CI，3.9 - 6.9）。糖尿病患者、糖调节受损者和非糖尿病患者的视网膜病变患病率分别为21.6%、13%和3.5%。葡萄糖代谢异常者发生视网膜病变的校正比值比为2.53（95%CI 1.52 - 5.41），高血压、HbA1c和UACR者的校正比值比分别为1.98（95%CI 1.17 - 5.63）、1.74（95%CI 1.09 - 3.02）和1.63（95%CI 1.08 - 3.12）。此外，年龄、体重指数、甘油三酯和总胆固醇也被发现是该人群发生视网膜病变的重要独立风险指标。
在这个孟加拉国农村人群中观察到视网膜病变的高患病率。除了控制糖尿病患者的血糖外，筛查高血压、肥胖、高脂血症和蛋白尿以及对这些风险指标进行充分治疗可能预防孟加拉国农村人群的视网膜病变。
