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早期评估糖尿病视网膜病变的危险因素可降低2型糖尿病患者外周动脉疾病和心血管疾病的风险。

Early Assessment of the Risk Factors for Diabetic Retinopathy Can Reduce the Risk of Peripheral Arterial and Cardiovascular Diseases in Type 2 Diabetes.

作者信息

Tang Juan, Li Tao, Li Pinhong, Ma Yuefei, Liu Momo, Shan Qiaoyun, Guo Fengqi, Zhou Ting, Wei Qianping

出版信息

Ophthalmic Res. 2018;59(4):221-227. doi: 10.1159/000479931. Epub 2017 Sep 21.

Abstract

BACKGROUNDS

There is still a lack of consensus about how to assess the risk of peripheral arterial disease (PAD) and cardiovascular disease (CVD) in patients with diabetic retinopathy (DR).

AIMS

We investigated the risk factors for DR and their association with PAD and CVD in patients with type 2 diabetes (T2D).

METHODS

A total of 1,421 patients diagnosed with T2D participated in this study. DR stages were classified as non-DR, nonproliferative DR (NPDR), or proliferative DR (PDR). Logistic regression analysis was employed to analyze risk factors associated with DR.

RESULTS

NPDR and PDR patients had higher systolic blood pressure (SBP) and higher levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) than the non-DR group (p < 0.05). The prevalence of abnormal ankle-brachial index (ABI) in the non-DR, NPDR, and PDR groups was 7.00, 10.80, and 13.96%, respectively (p < 0.05) and the prevalence of peripheral arterial plaques was 68.48, 81.38, and 80.56%, respectively (p < 0.001). Logistic regression analysis showed that DR (vs. non-DR) was associated with peripheral arterial plaques (OR = 2.07), SBP ≥130 mm Hg (OR = 1.53) and levels of hemoglobin (Hb)A1c (OR = 2.11) and TC (OR = 1.42).

CONCLUSION

PAD is commonly associated with NPDR and PDR. Hypercholesterolemia is an important risk factor for the development of PAD and CVD in patients with DR. Our results suggest that a routine ABI test, duplex ultrasonography, and obtaining a lipid profile for DR patients may help to reduce the occurrence of PAD and CVD.

摘要

背景

对于如何评估糖尿病视网膜病变(DR)患者外周动脉疾病(PAD)和心血管疾病(CVD)的风险,目前仍缺乏共识。

目的

我们调查了2型糖尿病(T2D)患者DR的危险因素及其与PAD和CVD的关联。

方法

共有1421例确诊为T2D的患者参与了本研究。DR阶段分为非DR、非增殖性DR(NPDR)或增殖性DR(PDR)。采用逻辑回归分析来分析与DR相关的危险因素。

结果

NPDR和PDR患者的收缩压(SBP)、总胆固醇(TC)和低密度脂蛋白胆固醇(LDL-C)水平高于非DR组(p<0.05)。非DR、NPDR和PDR组中踝臂指数(ABI)异常的患病率分别为7.00%、10.80%和13.96%(p<0.05),外周动脉斑块的患病率分别为68.48%、81.38%和80.56%(p<0.001)。逻辑回归分析显示,DR(与非DR相比)与外周动脉斑块(比值比[OR]=2.07)、SBP≥130mmHg(OR=1.53)、糖化血红蛋白(Hb)A1c水平(OR=2.11)和TC水平(OR=1.42)相关。

结论

PAD通常与NPDR和PDR相关。高胆固醇血症是DR患者发生PAD和CVD的重要危险因素。我们的结果表明,对DR患者进行常规ABI检测、双功超声检查以及获取血脂谱可能有助于降低PAD和CVD的发生。

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