Azzoug Said, Chentli Farida
Department of Endocrine and Metabolic Diseases, Bab El Oued Hospital, 5boulevard Said Touati, Algiers, 16000, Algeria.
Indian J Endocrinol Metab. 2014 May;18(3):407-9. doi: 10.4103/2230-8210.131207.
Although growth hormone (GH) has been implicated in the pathogenesis of diabetic retinopathy (DR), DR is deemed to be rare in patients with GH excess. Our aim was to study its prevalence in subjects with acromegaly suffering from diabetes mellitus (DM), to analyze its characteristics, and to look for predictive factors such as age at diagnosis, GH concentration and duration, DM duration, DM control, and family background.
Forty patients with acromegaly and DM (21 males, 19 females), median age = 50 years, underwent a systematic ophthalmological examination with dilated funduscopy to seek diabetic retinopathy.
Among this population, 05 (12.5%) had DR. It was at an early stage or background retinopathy in 3 cases and at a more advanced stage or proliferative retinopathy in 2 cases. We did not find any correlation with age at diagnosis, GH levels and duration, DM duration and family history of DM, but poor glycemic control seems to play a role although statistical analysis showed borderline significance.
From this study, we conclude that prevalence of DR in patients with acromegaly is 12.5%, and it is slight or moderate. Among studied factors, only poor glycemic control seems to be implicated in its development.
尽管生长激素(GH)被认为与糖尿病视网膜病变(DR)的发病机制有关,但在生长激素分泌过多的患者中,DR被认为是罕见的。我们的目的是研究肢端肥大症合并糖尿病(DM)患者中DR的患病率,分析其特征,并寻找预测因素,如诊断时的年龄、GH浓度和病程、DM病程、DM控制情况以及家族背景。
40例肢端肥大症合并DM患者(男21例,女19例),中位年龄50岁,接受了散瞳眼底镜的系统眼科检查以筛查糖尿病视网膜病变。
在这组人群中,5例(12.5%)患有DR。其中3例处于早期或背景性视网膜病变阶段,2例处于更晚期或增殖性视网膜病变阶段。我们未发现其与诊断时的年龄、GH水平和病程、DM病程以及DM家族史之间存在任何相关性,但血糖控制不佳似乎起了作用,尽管统计分析显示其具有临界显著性。
通过本研究,我们得出结论,肢端肥大症患者中DR的患病率为12.5%,程度较轻或中等。在所研究的因素中,只有血糖控制不佳似乎与DR的发生有关。