Larsen Morten B, Henriksen Jan Erik, Grauslund Jakob, Peto Tunde
NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust, UCL Institute of Ophthalmology, London, UK.
Research Unit of Ophthalmology, Department of Clinical Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark.
Acta Ophthalmol. 2017 Dec;95(8):778-786. doi: 10.1111/aos.13449. Epub 2017 Apr 26.
This study aims to estimate the prevalence and risk factors of diabetic retinopathy (DR) in patients enrolled in a large Danish quality-assuring database for diabetes: the Funen Diabetes Database (FDDB).
All patients with type 1 (T1DM) and type 2 DM (T2DM) diabetes mellitus (DM) were included in a cross-sectional study. The level of DR per patient was determined based on the eye with highest level of DR. All ocular and non-ocular data were extracted at the latest examination that corresponded to the most recent DR-grading data.
Data from 17 152 patients were analysed; 83.1% had T2DM. Prevalence of DR was 23.8% (T1DM: 54.3%, T2DM: 21.2%). T1/T2DM patients were statistically significantly different regarding age, duration of diabetes, BMI, systolic blood pressure (BP), cholesterol, LDL cholesterol, HDL cholesterol, triglyceride, s-creatinine and u-albumin (p < 0.001 for all). Increasing level of DR showed statistically significant association with age, duration of diabetes, systolic BP, HbA1c, s-creatinine and u-albumine with increasing level of DR (all are p < 0.001) both T1DM/T2DM patients.
The patients in FDDB had good systemic control with median values of BP, serum lipids, cholesterol and HbA1c all close to or below national guidelines at the time of data extraction, but still a high level of DR was found in this cohort. DR was more common in patients with T1DM than T2DM, but as T2DM patients are more numerous, their level of DR despite acceptable control is still concerning. Most important associated factors for higher levels of DR were age, duration of diabetes, HbA1c, s-creatinine and u-albumine.
本研究旨在评估丹麦一个大型糖尿病质量保证数据库——菲英岛糖尿病数据库（FDDB）中登记患者的糖尿病视网膜病变（DR）患病率及危险因素。
所有1型糖尿病（T1DM）和2型糖尿病（T2DM）患者均纳入一项横断面研究。根据患者DR水平最高的那只眼睛来确定每位患者的DR水平。所有眼部和非眼部数据均在与最新DR分级数据对应的最近一次检查时提取。
分析了17152例患者的数据；83.1%为T2DM患者。DR患病率为23.8%（T1DM：54.3%，T2DM：21.2%）。T1/T2DM患者在年龄、糖尿病病程、体重指数、收缩压（BP）、胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、甘油三酯、血清肌酐和尿白蛋白方面存在统计学显著差异（所有p<0.001）。DR水平升高与年龄、糖尿病病程、收缩压、糖化血红蛋白、血清肌酐和尿白蛋白呈统计学显著相关，且随着DR水平升高，T1DM/T2DM患者均如此（所有p<0.001）。
FDDB中的患者全身控制良好，在数据提取时，血压、血脂、胆固醇和糖化血红蛋白的中位数均接近或低于国家指南，但该队列中仍发现较高水平的DR。DR在T1DM患者中比T2DM患者更常见，但由于T2DM患者数量更多，尽管控制尚可，其DR水平仍令人担忧。DR水平升高的最重要相关因素是年龄、糖尿病病程、糖化血红蛋白、血清肌酐和尿白蛋白。
