Cantagallo A
Ann Ig. 1989 May-Aug;1(3-4):591-620.
About 5% of total world population is affected by diabetes mellitus syndrome, with an expected increasing trend in the next years. Retinopathy, among the different diabetic complications, is the second cause (being cataract the first) of legal blindness in the industrialized countries. The range of results obtained from prevalence studies, mainly conducted in Anglo-saxon countries, varies from 5% to 70% in connection with the following risk factors: patient's age at the diagnosis date, duration of disease, metabolic control, arterial hypertension and lipidoproteinosis. Smoke and alcohol do not seem to be statistically relevant. The most probable mechanisms causing the retinopathy onset have been identified in the tissue hypoxia and in the vascular occlusion: the former is induced by the HA1c increase associated with hyperglycaemia; this is due to structural and hemorheologic alterations associated with diabetes syndrome. This study analysis the relations between diabetic retinopathy and beta-cellular reserve and cardio-vascular risk factors. 181 diabetics have been considered, subdivided into three groups: Type I diabetics and Type II diabetics and Type II diabetics (both without considering the duration of disease) and diabetics with over 10 years of disease. In each group the correlations between retinopathy severity and cardiovascular risk factors and beta-cellular reserve have been investigated. The results confirm that patient's age, duration of disease and metabolic control are statistically significant in relation to retinal lesion severity. The investigation on beta-cellular reserve, even though the results are not statistically significant, presents a trend towards lower values in more severe retinopathy.
全球约5%的人口受糖尿病综合征影响,预计未来几年这一比例还会上升。在不同的糖尿病并发症中,视网膜病变是工业化国家法定失明的第二大原因(白内障是第一大原因)。患病率研究主要在盎格鲁 - 撒克逊国家进行,其结果因以下风险因素而有所不同,范围在5%至70%之间:诊断时患者的年龄、病程、代谢控制情况、动脉高血压和脂蛋白血症。吸烟和饮酒似乎在统计学上并无关联。已确定导致视网膜病变发生的最可能机制是组织缺氧和血管阻塞:前者由与高血糖相关的糖化血红蛋白(HA1c)升高引起;这是由于糖尿病综合征相关的结构和血液流变学改变所致。本研究分析了糖尿病视网膜病变与β细胞储备及心血管危险因素之间的关系。研究共纳入181名糖尿病患者,分为三组:1型糖尿病患者、2型糖尿病患者(均未考虑病程)以及病程超过10年的2型糖尿病患者。在每组中,均对视网膜病变严重程度与心血管危险因素及β细胞储备之间的相关性进行了研究。结果证实,患者的年龄、病程和代谢控制情况与视网膜病变严重程度在统计学上具有显著相关性。对β细胞储备的研究尽管结果在统计学上不显著,但在更严重的视网膜病变中呈现出β细胞储备值较低的趋势。