Raum Philipp, Lamparter Julia, Ponto Katharina A, Peto Tunde, Hoehn René, Schulz Andreas, Schneider Astrid, Wild Philipp S, Pfeiffer Norbert, Mirshahi Alireza
Department of Ophthalmology, University Medical Center, Mainz, Germany.
Department of Ophthalmology, University Medical Center, Mainz, Germany; Center for thrombosis & haemostasis (CTH), University Medical Center, Mainz, Germany.
PLoS One. 2015 Jun 15;10(6):e0127188. doi: 10.1371/journal.pone.0127188. eCollection 2015.
Diabetic retinopathy (DR) is the leading cause of blindness in people of working age. The purpose of this paper is to report the prevalence and cardiovascular associations of diabetic retinopathy and maculopathy (DMac) in Germany.
The Gutenberg Health Study (GHS) is a population-based study with 15,010 participants aged between 35 at 74 years from the city of Mainz and the district of Mainz-Bingen. We determined the weighted prevalence of DR and DMac by assessing fundus photographs of persons with diabetes from the GHS data base. Diabetes was defined as HbA1c ≥ 6.5%, known diagnosis diabetes mellitus or known diabetes medication. Furthermore, we analysed the association between DR and cardiovascular risk factors and diseases.
Overall, 7.5% (1,124/15,010) of the GHS cohort had diabetes. Of these, 27.7% were unaware of their disease and thus were newly diagnosed by their participation in the GHS. The prevalence of DR and DMac was 21.7% and 2.3%, respectively among patients with diabetes. Vision-threatening disease was present in 5% of the diabetic cohort. In the multivariable analysis DR (all types) was associated with age (Odds Ratio [95% confidence interval]: 0.97 [0.955-0.992]; p = 0.006) arterial hypertension (1.90 [1.190-3.044]; p = 0.0072) and vision-threatening DR with obesity (3.29 [1.504-7.206]; p = 0.0029). DR (all stages) and vision-threatening DR were associated with duration of diabetes (1.09 [1.068-1.114]; p<0.0001 and 1.18 [1.137-1.222]; p<0.0001, respectively).
Our calculations suggest that approximately 142 000 persons aged between 35 and 74 years have vision threatening diabetic retinal disease in Germany [corrected].Prevalence of DR was lower in the GHS compared to East-Asian studies. Associations were found with age, arterial hypertension, obesity, and duration of diabetes mellitus.
糖尿病视网膜病变（DR）是工作年龄段人群失明的主要原因。本文旨在报告德国糖尿病视网膜病变和黄斑病变（DMac）的患病率及其与心血管疾病的关联。
古登堡健康研究（GHS）是一项基于人群的研究，共有来自美因茨市和美因茨-宾根区的15010名年龄在35至74岁之间的参与者。我们通过评估GHS数据库中糖尿病患者的眼底照片来确定DR和DMac的加权患病率。糖尿病的定义为糖化血红蛋白（HbA1c）≥6.5%、已知糖尿病诊断或正在接受糖尿病治疗。此外，我们分析了DR与心血管危险因素及疾病之间的关联。
总体而言，GHS队列中有7.5%（1124/15010）的人患有糖尿病。其中，27.7%的人此前未意识到自己患病，因此是通过参与GHS而被新诊断出糖尿病的。糖尿病患者中DR和DMac的患病率分别为21.7%和2.3%。5%的糖尿病患者存在威胁视力的疾病。在多变量分析中，DR（所有类型）与年龄（比值比[95%置信区间]：0.97[0.955 - 0.992]；p = 0.006）、动脉高血压（1.90[1.190 - 3.044]；p = 0.0072）相关，而威胁视力的DR与肥胖相关（3.29[1.504 - 7.206]；p = 0.0029）。DR（所有阶段）和威胁视力的DR均与糖尿病病程相关（分别为1.09[1.068 - 1.114]；p<0.0001和1.18[1.137 - 1.222]；p<0.0001）。
我们的计算结果表明，在德国，年龄在35至74岁之间约有14.2万人患有威胁视力的糖尿病视网膜疾病[已修正]。与东亚的研究相比，GHS中DR的患病率较低。研究发现DR与年龄、动脉高血压、肥胖及糖尿病病程有关。
