Yang Xiufen, Deng Yu, Gu Hong, Ren Xuetao, Lim Apiradee, Snellingen Torkel, Liu Xipu, Wang Ningli, Won Pak Jeong, Liu Ningpu, Danis Ronald P
Department of Ophthalmology, The Friendship Hospital, Capital Medical University, Beijing, China Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China.
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China.
Br J Ophthalmol. 2016 Oct;100(10):1359-65. doi: 10.1136/bjophthalmol-2014-306078. Epub 2016 Jan 28.
To describe the relationship of retinal arteriolar and venular calibre with diabetic retinopathy (DR) and related risk factors, including glucose levels and other biomarkers in a Chinese population with type 2 diabetes mellitus (T2DM).
A cross-sectional study. Patients with T2DM were recruited from a local community in urban Beijing. Seven fields 30° colour fundus photographs were taken and examined for the presence and severity of DR using a standardised grading system. Retinal vascular calibres were measured and expressed as average central retinal arteriolar and venular equivalent using a computer-based program.
A total of 1340 patients with T2DM were included for analysis. Of these, 472 (35.22%) had DR. Wider retinal venular calibre, but not arteriolar calibre, was associated with increasing glucose and glycosylated haemoglobin A1c levels (p<0.006) and dyslipidaemia (p for trend <0.05). After adjusting for possible covariates, the higher quartile of retinal venular calibre was associated with higher prevalence of any DR (OR 2, 95% CI 1.36 to 2.95). Venular calibre increased from 224.33 μm in those without retinopathy to 231.21 μm in those with mild, 241.01 μm in those with moderate and 235.65 μm in those with severe retinopathy (p for trend <0.001). Arteriolar calibre was not associated with DR.
In the current study, wider venular calibre, but not arteriolar calibre, was shown to be associated with development and increased severity of DR independently from other risk factors in a Chinese diabetic population.
描述中国2型糖尿病（T2DM）人群中视网膜小动脉和小静脉管径与糖尿病视网膜病变（DR）及相关危险因素（包括血糖水平和其他生物标志物）之间的关系。
一项横断面研究。从北京城区的一个当地社区招募T2DM患者。拍摄七张30°彩色眼底照片，并使用标准化分级系统检查DR的存在情况和严重程度。使用基于计算机的程序测量视网膜血管管径，并以平均中央视网膜小动脉和小静脉等效值表示。
共纳入1340例T2DM患者进行分析。其中，472例（35.22%）患有DR。较宽的视网膜小静脉管径而非小动脉管径与血糖和糖化血红蛋白A1c水平升高（p<0.006）以及血脂异常（趋势p<0.05）相关。在调整可能的协变量后，视网膜小静脉管径的较高四分位数与任何DR的较高患病率相关（比值比2，95%置信区间1.36至2.95）。小静脉管径从无视网膜病变者的224.33μm增加到轻度病变者的231.21μm、中度病变者的241.01μm和重度病变者的235.65μm（趋势p<0.001）。小动脉管径与DR无关。
在本研究中，在中国糖尿病患者人群中，较宽的小静脉管径而非小动脉管径被证明与DR的发生和严重程度增加独立于其他危险因素相关。
