Wat N, Wong R Lm, Wong I Yh
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong.
Hong Kong Eye Hospital, Argyle Street, Hong Kong.
Hong Kong Med J. 2016 Dec;22(6):589-99. doi: 10.12809/hkmj164869. Epub 2016 Oct 24.
Diabetes mellitus is a systemic disease with complications that include sight-threatening diabetic retinopathy. It is essential to understand the risk factors of diabetic retinopathy before effective prevention can be implemented. The aim of this review was to examine the association between diabetic retinopathy and systemic risk factors.
A PubMed literature search was performed up to May 2016 to identify articles reporting associations between diabetic retinopathy and systemic risk factors; only publications written in English were included. Relevant articles were selected and analysed.
Patients with diabetic retinopathy were more likely to have poor glycaemic control as reflected by a higher glycated haemoglobin, longer duration of diabetes, and use of insulin therapy for treatment. For other systemic risk factors, hypertension was positively associated with prevalence and progression of diabetic retinopathy. No clear association between obesity, hyperlipidaemia, gender, or smoking with diabetic retinopathy has been established as studies reported inconsistent findings. Myopia was a protective factor for the development of diabetic retinopathy. Several genetic polymorphisms were also found to be associated with an increased risk of development of diabetic retinopathy.
Good glycaemic and blood pressure control remain the most important modifiable risk factors to reduce the risk of progression of diabetic retinopathy and vision loss.
糖尿病是一种全身性疾病，其并发症包括威胁视力的糖尿病视网膜病变。在实施有效预防措施之前，了解糖尿病视网膜病变的危险因素至关重要。本综述的目的是研究糖尿病视网膜病变与全身危险因素之间的关联。
截至2016年5月，在PubMed上进行文献检索，以识别报告糖尿病视网膜病变与全身危险因素之间关联的文章；仅纳入英文撰写的出版物。选择并分析相关文章。
糖尿病视网膜病变患者更有可能血糖控制不佳，表现为糖化血红蛋白水平较高、糖尿病病程较长以及使用胰岛素治疗。对于其他全身危险因素，高血压与糖尿病视网膜病变的患病率和进展呈正相关。由于研究报告结果不一致，肥胖、高脂血症、性别或吸烟与糖尿病视网膜病变之间尚未确立明确关联。近视是糖尿病视网膜病变发生的一个保护因素。还发现几种基因多态性与糖尿病视网膜病变发生风险增加有关。
良好的血糖和血压控制仍然是降低糖尿病视网膜病变进展和视力丧失风险的最重要的可改变危险因素。
