Mattern Juri, Lammert Alexander, Otto Mirko, Hammes Hans-Peter
5th Medical Department, Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany.
Surgical Department, Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany.
Br J Ophthalmol. 2017 Nov;101(11):1550-1554. doi: 10.1136/bjophthalmol-2016-309566. Epub 2017 Mar 17.
To assess retinopathy and its risk factors in an obesity WHO III cohort.
In the , 277 subjects with obesity WHO III aged 18-64 years were examined in a cross-sectional approach. Screening for retinopathy was performed using 3-field retinal photography. Endothelial function was assessed using arteriole-to-venule ratio and flicker light analysis. Subjects with and without retinopathy were analysed for anthropometry, metabolic, vascular and renal parameters.
Retinopathy was found in 18 of the 277 subjects (6.5%). Prevalence of retinopathy was 16.7% in subjects with and 3.4% in subjects without diabetes mellitus. Between subjects with and without retinopathy there were significant differences in diabetes prevalence (61.1% vs 21.7%, p<0.001), systolic blood pressure (145.56 vs 131.73 mm Hg, p=0.005), intima-media thickness (0.7 vs 0.59 mm, p=0.034), dilatation of retinal veins in response to flicker light (2.24% vs 4.28%, p=0.004) and creatinine (0.92 vs 0.83 mg/dL, p=0.011). Stepwise logistic regression analysis revealed that the presence of diabetes mellitus led to an 8.3-fold increased risk for retinopathy (OR 8.3, p=0.049, 95% CI 1.01 to 67.49), whereas risk for retinopathy decreased by nearly 50% (OR 0.54, p=0.032, 95% CI 0.30 to 0.95) with each percentage increase in venous dilatation in response to flicker light.
Retinopathy prevalence in our obesity WHO III cohort is low. Presence of diabetes mellitus is the most important risk factor for retinopathy. Preserved venular function indicates protection from retinopathy.
NCT00770276, Results.
评估世界卫生组织(WHO)III级肥胖人群中的视网膜病变及其危险因素。
采用横断面研究方法,对277名年龄在18 - 64岁的WHO III级肥胖受试者进行检查。使用3视野视网膜摄影术筛查视网膜病变。采用动静脉比和闪烁光分析评估内皮功能。对有和没有视网膜病变的受试者进行人体测量、代谢、血管和肾脏参数分析。
277名受试者中有18名(6.5%)发现有视网膜病变。糖尿病患者中视网膜病变患病率为16.7%,非糖尿病患者中为3.4%。有和没有视网膜病变的受试者在糖尿病患病率(61.1%对21.7%,p<0.001)、收缩压(145.56对131.73 mmHg,p = 0.005)、内膜中层厚度(0.7对0.59 mm,p = 0.034)、视网膜静脉对闪烁光的扩张(2.24%对4.28%,p = 0.004)和肌酐(0.92对0.83 mg/dL,p = 0.011)方面存在显著差异。逐步逻辑回归分析显示,糖尿病的存在使视网膜病变风险增加8.3倍(比值比8.3,p = 0.049,95%置信区间1.01至67.49),而随着视网膜静脉对闪烁光扩张每增加一个百分点,视网膜病变风险降低近50%(比值比0.54,p = 0.032,95%置信区间0.30至0.95)。
我们的WHO III级肥胖人群中视网膜病变患病率较低。糖尿病的存在是视网膜病变最重要的危险因素。保留的小静脉功能表明可预防视网膜病变。
NCT00770276,结果