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糖尿病视网膜病变的认知及其与多种合并症的关联:来自钻石研究的见解

Diabetic Retinopathy Awareness and Associations with Multiple Comorbidities: Insights from DIAMOND Study.

作者信息

Shah Kiran, Gandhi Alka, Natarajan Sundaram

机构信息

Director, Diabetes and Thyroid Care Center, Borivali West, Mumbai, India.

Director, Aayushi Diabetes Center, Mumbai, India.

出版信息

Indian J Endocrinol Metab. 2018 Jan-Feb;22(1):30-35. doi: 10.4103/ijem.IJEM_240_17.

Abstract

BACKGROUND

Diabetic retinopathy (DR) is leading cause of visual impairment in working-age adults. Macular edema can occur with or without other signs of retinopathy.

METHODS

This was a single-center, retrospective study conducted over 2 years in patients (>40 years of age) having type 2 diabetes mellitus (T2DM). Outcome measures were to analyze awareness and prevalence of DR and association of DR with identified risk factors.

RESULTS

Overall 6000 T2DM patients over 2 years were retrospectively evaluated. Almost 63% ( = 3780) of patients were unaware that diabetes affects the retina. Almost 65% ( = 3894) of patients were reported to have DR. Total 78.98% of males, and 69.50% of females had DR. There was a significant increase in the incidence of DR with age ( < 0.00001). Almost 60.80% ( = 3653) of patients having DR were from working age group (40-70 years). Evidently, 42% ( = 2520) of patients having DR had HbA1c > 9% ( < 0.00001). Overall 52.02% ( = 1820) of smokers were reported of DR ( < 0.00001). With the increase in total cholesterol and triglycerides, there was a significant increase in DR incidence ( < 0.00001). A strong association was observed between hypertension and DR, with 42.6% ( = 2556) of patients having coexistence of hypertension and DR ( < 0.00001). Patients having diabetic kidney disease (DKD) also reported DR. A high proportion of patients (49.11%, = 2947) had co-existence of cardiac morbidity and DR. Almost 47% ( = 2845) of patients having DR were also reported anemia. Totally 43.85% ( = 2631) of patients with microalbuminuria had two times more risk of developing proliferative DR ( < 0.00001). The statistical significance for the association of DR with risk factors, calculated by Pearson Chi-Square method of analysis was found statistically significant ( < 0.00001).

CONCLUSION

The study reported the high prevalence and significantly high unawareness for DR in T2DM patients. All the risk factors are independently and significantly associated with DR ( < 0.00001).

摘要

背景

糖尿病视网膜病变(DR)是工作年龄成年人视力损害的主要原因。黄斑水肿可伴有或不伴有视网膜病变的其他体征。

方法

这是一项在2年时间里对2型糖尿病(T2DM)患者(年龄>40岁)进行的单中心回顾性研究。结果指标是分析DR的知晓率和患病率以及DR与已确定风险因素的关联。

结果

对2年期间的6000例T2DM患者进行了回顾性评估。几乎63%(n = 3780)的患者不知道糖尿病会影响视网膜。据报告,几乎65%(n = 3894)的患者患有DR。男性DR总发生率为78.98%,女性为69.50%。DR的发病率随年龄显著增加(P < 0.00001)。几乎60.80%(n = 3653)患有DR的患者来自工作年龄组(40 - 70岁)。显然,42%(n = 2520)患有DR的患者糖化血红蛋白>9%(P < 0.00001)。总体而言,52.02%(n = 1820)的吸烟者被报告患有DR(P < 0.00001)。随着总胆固醇和甘油三酯水平升高,DR发病率显著增加(P < 0.00001)。观察到高血压与DR之间存在强关联,42.6%(n = 2556)的患者同时患有高血压和DR(P < 0.00001)。患有糖尿病肾病(DKD)的患者也报告患有DR。很大比例的患者(49.11%,n = 2947)同时患有心脏疾病和DR。几乎47%(n = 2845)患有DR的患者也被报告患有贫血。共有43.85%(n = 2631)的微量白蛋白尿患者发生增殖性DR的风险高出两倍(P < 0.00001)。采用Pearson卡方分析方法计算得出DR与风险因素之间的关联具有统计学意义(P < 0.00001)。

结论

该研究报告了T2DM患者中DR的高患病率以及显著的高知晓率不足。所有风险因素均与DR独立且显著相关(P < 0.00001)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cda6/5838906/add00b7f6e13/IJEM-22-30-g002.jpg

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