Luo Huabin, Bell Ronny A, Garg Seema, Cummings Doyle M, Patil Shivajirao P, Jones Katherine
assistant professor, Department of Public Health, East Carolina University, Greenville, North Carolina
professor and chair, Department of Public Health, East Carolina University, Greenville, North Carolina.
N C Med J. 2019 Mar-Apr;80(2):76-82. doi: 10.18043/ncm.80.2.76.
There is limited information available in North Carolina on the current burden of, and racial disparities in, diabetic retinopathy (DR), a major complication associated with diabetes mellitus (DM). This study aims to describe the overall trend of, and racial/ethnic disparities in, DR among adults with DM in North Carolina. Data were from 13 waves (2000, 2002-2010, 2012, 2013, and 2015) of the Behavioral Risk Factor Surveillance System. The study sample included 16,976 adults aged ≥ 40 years with DM in North Carolina. DR was identified by self-report by the question, "Has a doctor ever told you that diabetes has affected your eyes or that you had retinopathy?" The overall prevalence of DR was assessed during the time period, and was compared between whites and blacks. All analyses were conducted using Stata 13.0. The prevalence of self-reported DR in North Carolina decreased from 27.2% in 2000 to 18.3% in 2015, a reduction of 33% (Trend = .003). The age-adjusted DR prevalence in whites decreased from 21.7% to 17.6% (Trend = .04), and in blacks from 39.4% to 20.2% (Trend = .002). The declining rates in DR were not statistically different between whites and blacks ( = .06). Blacks were more likely to report DR (adjusted odds ratio = 1.20, 95% confidence interval, 1.03-1.40) during 2000-2015. The prevalence of self-reported DR in adults with DM declined significantly in North Carolina in the past 15 years. While racial differences in some years appeared to be decreasing, the black-white disparity in DR prevalence during the entire period persisted. Focused efforts on reducing the gap are needed.
北卡罗来纳州关于糖尿病视网膜病变（DR）——糖尿病（DM）的一种主要并发症——当前的负担及种族差异的可用信息有限。本研究旨在描述北卡罗来纳州成年糖尿病患者中糖尿病视网膜病变的总体趋势及种族/族裔差异。数据来自行为危险因素监测系统的13个波次（2000年、2002 - 2010年、2012年、2013年和2015年）。研究样本包括北卡罗来纳州16976名年龄≥40岁的成年糖尿病患者。通过自我报告问题“医生是否曾告诉你糖尿病影响了你的眼睛或你患有视网膜病变？”来确定糖尿病视网膜病变。在此期间评估了糖尿病视网膜病变的总体患病率，并在白人和黑人之间进行了比较。所有分析均使用Stata 13.0进行。北卡罗来纳州自我报告的糖尿病视网膜病变患病率从2000年的27.2%降至2015年的18.3%，降幅为33%（趋势 = 0.003）。白人中年龄调整后的糖尿病视网膜病变患病率从21.7%降至17.6%（趋势 = 0.04），黑人从39.4%降至20.2%（趋势 = 0.002）。糖尿病视网膜病变的下降率在白人和黑人之间无统计学差异（P = 0.06）。在2000 - 2015年期间，黑人更有可能报告患有糖尿病视网膜病变（调整后的优势比 = 1.20，95%置信区间，1.03 - 1.40）。在过去15年中，北卡罗来纳州成年糖尿病患者自我报告的糖尿病视网膜病变患病率显著下降。虽然某些年份种族差异似乎在减小，但整个期间糖尿病视网膜病变患病率的黑白差距依然存在。需要集中努力来缩小差距。
