Liu Yan, Yang Jiarui, Tao Liyuan, Lv Huibin, Jiang Xiaodan, Zhang Mingzhou, Li Xuemin
Department of Ophthalmology, Peking University Third Hospital, Beijing, China.
Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China.
BMJ Open. 2017 Sep 1;7(9):e016280. doi: 10.1136/bmjopen-2017-016280.
To explore the risk factors of diabetic retinopathy (DR) and sight-threatening diabetic retinopathy (STDR) among Chinese patients with diabetes.
DESIGN, SETTING AND PARTICIPANTS: A cross-sectional investigation was performed in eight screening clinics in six provinces across mainland China. Information about the risk factors was recorded in screening clinics. Some risk factors (sex, age, diagnosis age, diabetes duration, systolic blood pressure (SBP), diastolic blood pressure, fasting blood glucose (FBG) and glycosylated haemoglobin (HbA1c)) were recorded in all eight clinics, while others were collected only in a subset of the clinics. The relationships between the risk factors and DR and between the risk factors and STDR were explored for the eight factors mentioned above and for all factors studied.
Risk factors of DR and STDR were assessed, and a nomogram of the results was produced.
Younger age, longer diabetes duration, higher SBP, higher FBG and higher HbA1c were found to be independent risk factors for both DR and STDR in the eight-factor analyses. In the all-factor analysis, younger age, longer diabetes duration, higher SBP, oral medicine use and insulin use were independent risk factors for both DR and STDR; higher postprandial blood glucose (PBG), HbA1c, triglyceride andlow-density lipoprotein were independent risk factors for DR only, and higher FBG was a risk factor for STDR only.
In this cross-sectional investigation, several risk factors were found for DR and STDR. Notably, FBG, PBG and HbA1c were all risk factors for DR or STDR, suggesting that stricter blood glucose control in clinical practice is required.
探讨中国糖尿病患者中糖尿病视网膜病变（DR）及威胁视力的糖尿病视网膜病变（STDR）的危险因素。
设计、地点和参与者：在中国大陆六个省份的八家筛查诊所进行了一项横断面调查。危险因素信息在筛查诊所记录。部分危险因素（性别、年龄、诊断年龄、糖尿病病程、收缩压（SBP）、舒张压、空腹血糖（FBG）和糖化血红蛋白（HbA1c））在所有八家诊所记录，而其他因素仅在部分诊所收集。针对上述八个因素以及所有研究因素，探讨了危险因素与DR之间以及危险因素与STDR之间的关系。
评估DR和STDR的危险因素，并生成结果的列线图。
在八因素分析中，年龄较小、糖尿病病程较长、SBP较高、FBG较高和HbA1c较高被发现是DR和STDR的独立危险因素。在全因素分析中，年龄较小、糖尿病病程较长、SBP较高、使用口服药物和使用胰岛素是DR和STDR的独立危险因素；餐后血糖（PBG）、HbA1c、甘油三酯和低密度脂蛋白较高仅是DR的独立危险因素，而FBG较高仅是STDR的危险因素。
在这项横断面调查中，发现了DR和STDR的几个危险因素。值得注意的是，FBG、PBG和HbA1c均为DR或STDR的危险因素，这表明临床实践中需要更严格地控制血糖。
