Penman Alan, Hancock Heather, Papavasileiou Evangelia, James Maurice, Idowu Omolola, Riche Daniel M, Fernandez Marlene, Brauner Stacey, Smith Sataria O, Hoadley Suzanne, Richardson Cole, Vazquez Vanessa, Chi Cheryl, Andreoli Christopher, Husain Deeba, Chen Ching J, Sobrin Lucia
a Department of Medicine , University of Mississippi Medical Center , Jackson , MS , USA.
b Center of Biostatistics and Bioinformatics , University of Mississippi Medical Center , Jackson , MS , USA.
Ophthalmic Epidemiol. 2016;23(2):88-93. doi: 10.3109/09286586.2015.1119287. Epub 2016 Mar 7.
To assess personal and demographic risk factors for proliferative diabetic retinopathy in African Americans with type 2 diabetes.
In this prospective, non-interventional, cross-sectional case-control study, 380 African Americans with type 2 diabetes were enrolled. Participants were recruited prospectively and had to have either: (1) absence of diabetic retinopathy after ≥10 years of type 2 diabetes, or (2) presence of proliferative diabetic retinopathy when enrolled. Dilated, 7-field fundus photographs were graded using the Early Treatment Diabetic Retinopathy Study scale. Covariates including hemoglobin A1C (HbA1C), blood pressure, height, weight and waist circumference were collected prospectively. Multivariate regression models adjusted for age, sex and site were constructed to assess associations between risk factors and proliferative diabetic retinopathy.
Proliferative diabetic retinopathy was associated with longer duration of diabetes (odds ratio, OR, 1.62, p < 0.001), higher systolic blood pressure (OR 1.65, p < 0.001) and insulin use (OR 6.65, p < 0.001) in the multivariate regression analysis. HbA1C was associated with proliferative diabetic retinopathy in the univariate analysis (OR 1.31, p = 0.002) but was no longer significant in the multivariate analysis.
In this case-control study of African Americans with type 2 diabetes, duration of diabetes, systolic hypertension and insulin use were strong risk factors for the development of proliferative diabetic retinopathy. Interestingly, HbA1C did not confer additional risk in this cohort.
评估非裔美国2型糖尿病患者增殖性糖尿病视网膜病变的个人及人口统计学风险因素。
在这项前瞻性、非干预性横断面病例对照研究中，招募了380名非裔美国2型糖尿病患者。参与者为前瞻性招募，必须满足以下条件之一：（1）2型糖尿病≥10年后无糖尿病视网膜病变；或（2）入组时患有增殖性糖尿病视网膜病变。使用糖尿病视网膜病变早期治疗研究量表对散瞳后的7视野眼底照片进行分级。前瞻性收集包括糖化血红蛋白（HbA1C）、血压、身高、体重和腰围在内的协变量。构建调整了年龄、性别和研究地点的多变量回归模型，以评估风险因素与增殖性糖尿病视网膜病变之间的关联。
在多变量回归分析中，增殖性糖尿病视网膜病变与糖尿病病程较长（比值比，OR，1.62，p<0.001）、收缩压较高（OR 1.65，p<0.001）和使用胰岛素（OR 6.65，p<0.001）相关。在单变量分析中，HbA1C与增殖性糖尿病视网膜病变相关（OR 1.31，p = 0.002），但在多变量分析中不再具有统计学意义。
在这项针对非裔美国2型糖尿病患者的病例对照研究中，糖尿病病程、收缩期高血压和胰岛素使用是增殖性糖尿病视网膜病变发生的强烈风险因素。有趣的是，在该队列中HbA1C并未增加额外风险。
