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, 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. 2014 Jun;92(4):316-22. doi: 10.1111/aos.12199. Epub 2013 Jul 31.
To determine the prevalence and risk factors for retinopathy in a nondiabetic population.
The study population included 5869 participants without diabetes aged 38-87 years from the Tromsø Eye Study, a substudy of the population-based Tromsø Study in Norway. Retinal images from both eyes were graded for retinopathy. We collected data on risk factors from self-report questionnaires, clinical examinations, laboratory measurements and case note reviews. The cross-sectional relationship between potential risk factors and retinopathy was assessed using logistic regression analysis.
The overall prevalence of retinopathy was 14.8%. Men had a higher prevalence of retinopathy compared with women (15.9% versus 14.0%, p=0.04). In men, retinopathy was associated with hypertension (odds ratio [OR], 1.59; 95% confidence interval [CI], 1.24-2.04) and HbA1c (OR per %, 1.41; 95% CI, 1.01-1.96). In women, retinopathy was associated with age (OR per 10 years, 1.32; 95% CI, 1.14-1.52), log-transformed urinary albumin excretion (OR per log unit, 1.46; 95% CI, 1.14-1.87) and hypertension (OR, 1.36; 95% CI, 1.08-1.71). In women, retinopathy was associated with very low levels of urinary albumin excretion (urinary albumin/creatinine ratio >0.43 mg/mmol).
This study confirms results from previous studies on the strong association between blood pressure and retinopathy. A novel finding is the sex differences in risk factors for retinopathy, suggesting a sex difference in the pathogenesis leading to retinopathy.
确定非糖尿病人群中视网膜病变的患病率和危险因素。
研究人群包括来自挪威特罗姆瑟研究人群的一个子研究——特罗姆瑟眼研究中的 5869 名年龄在 38-87 岁之间的无糖尿病参与者。对双眼的视网膜图像进行视网膜病变分级。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危险因素数据。使用逻辑回归分析评估潜在危险因素与视网膜病变之间的横断面关系。
视网膜病变的总体患病率为 14.8%。男性的视网膜病变患病率高于女性（15.9%比 14.0%，p=0.04）。在男性中，视网膜病变与高血压（比值比 [OR]，1.59；95%置信区间 [CI]，1.24-2.04）和糖化血红蛋白（HbA1c）（每%的 OR，1.41；95%CI，1.01-1.96）相关。在女性中，视网膜病变与年龄（每 10 年的 OR，1.32；95%CI，1.14-1.52）、尿白蛋白排泄的对数变换（每单位的 OR，1.46；95%CI，1.14-1.87）和高血压（OR，1.36；95%CI，1.08-1.71）相关。在女性中，视网膜病变与非常低水平的尿白蛋白排泄（尿白蛋白/肌酐比值>0.43mg/mmol）相关。
本研究证实了先前关于血压与视网膜病变之间强关联的研究结果。一个新的发现是视网膜病变危险因素存在性别差异，提示导致视网膜病变的发病机制存在性别差异。
