[黎巴嫩年轻1型糖尿病控制良好人群视网膜病变的患病率及危险因素]

[Prevalence and risk factors of retinopathy in a young Lebanese population with well controlled type I diabetes].

作者信息

Baz Patrick C, Antoun Joelle, Haddad Nour, Kourie Hampig

机构信息

Service d'ophtalmologie, CHU Hôtel-Dieu de France.

出版信息

J Med Liban. 2013 Jul-Sep;61(3):132-7.

PMID:24422362

Abstract

PURPOSE

To assess the prevalence of diabetic retinopathy (DR) in a young population with type I diabetes in Lebanon, to compare it to its prevalence worldwide according to the literature, and to analyze its potential risk factors.

METHODS

Screening for DR by fundus examination was performed in patients > 10 years and diabetic for over 8 years attending the Chronic Care Center (CCC) in Lebanon. Data regarding patients' age, duration of their diabetes, body mass index, systolic and diastolic blood pressure, smoking habits, dyslipidemia, microalbuminuria, mean HbA1c over the past five years, number of insulin injections, parents' educational level and geographical origin, were collected.

RESULTS

220 teenagers and young adults (103 males and 117 females) aged between 12 and 46 years (mean age 24.2 y) were included in the study. The prevalence of DR was 14.6%, comparable to recent studies of similar populations. A non-proliferative DR was found in 25 children (11.4%) and a proliferative DR in 7 patients (3.2%). The mean duration of diabetes was 153 +/- 6.0 y and mean HbA1c 8.0 +/- 1.1%. The prevalenc of DR was not significantly influenced by genders (p = 0.52), smoking habits (p = 0.125), monitoring of blood glucose (p = 0.812), dyslipidemia (p = 0.435), and obesity. However, patients with DR were significantly older than those without DR (p < 0.001), had a longer duration of diabetes (p < 0.001), and higher systolic and diastolic pressures (p < 0.001 and p = 0.01 respectively). The presence of nephropathy was directly correlated with DR (p < 0.001). Finally, the parents' region of origin and educational level were significant risk factors for the presence of DR (p = 0.05 and p < 0.001 respectively).

CONCLUSION

The prevalence of DR in young type I diabetic patients followed in the CCC in Lebanon is relatively low and comparable to that published worldwide, with a decrease during the last 25 years, due to a multidisciplinary approach and a centralized control of risk factors.

摘要

目的

评估黎巴嫩年轻I型糖尿病患者中糖尿病视网膜病变（DR）的患病率，根据文献将其与全球患病率进行比较，并分析其潜在危险因素。

方法

对黎巴嫩慢性护理中心（CCC）中年龄大于10岁且糖尿病病程超过8年的患者进行眼底检查以筛查DR。收集有关患者年龄、糖尿病病程、体重指数、收缩压和舒张压、吸烟习惯、血脂异常、微量白蛋白尿、过去五年的平均糖化血红蛋白（HbA1c）、胰岛素注射次数、父母教育水平和地理来源的数据。

结果

220名年龄在12至46岁（平均年龄24.2岁）之间的青少年和年轻成年人（103名男性和117名女性）纳入研究。DR患病率为14.6%，与近期类似人群的研究结果相当。在25名儿童（11.4%）中发现非增殖性DR，7名患者（3.2%）中发现增殖性DR。糖尿病平均病程为153±6.0年，平均HbA1c为8.0±1.1%。DR患病率不受性别（p = 0.52）、吸烟习惯（p = 0.125）、血糖监测（p = 0.812）、血脂异常（p = 0.435）和肥胖的显著影响。然而，患有DR的患者明显比未患DR的患者年龄大（p < 0.001），糖尿病病程更长（p < 0.001），收缩压和舒张压更高（分别为p < 0.001和p = 0.01）。肾病的存在与DR直接相关（p < 0.001）。最后，父母的原籍地区和教育水平是DR存在的重要危险因素（分别为p = 0.05和p < 0.001）。