糖尿病视网膜病变发生过程中涉及的多种风险因素评估。
Evaluation of multiple risk factors involved in the development of Diabetic Retinopathy.
作者信息
Anwar Syeda Birjees, Asif Naveed, Naqvi Syed Abid Hassan, Malik Sidra
机构信息
Syeda Birjees Anwar, Department of Chemical Pathology, Armed Forces Institute of Pathology, Rawalpindi, Pakistan.
Naveed Asif, Department of Chemical Pathology, Armed Forces Institute of Pathology, Rawalpindi, Pakistan.
出版信息
Pak J Med Sci. 2019 Jan-Feb;35(1):156-160. doi: 10.12669/pjms.35.1.279.
OBJECTIVE
To determine the role of hypertension, hyperlipidemia, smoking and positive family history of diabetes and hypertension in the development of diabetic retinopathy.
METHODS
This prospective cohort study was conducted at the Department of Chemical Pathology, Armed Forces Institute of Pathology, Rawalpindi over 2 years period from June 2014 to June 2016. One hundred consecutive diabetic patients with no signs of diabetic retinopathy and good glycemic control (HbA1c<6.5%) were registered by non-probability convenient sampling after taking written informed consent. They were evaluated for hypertension, hyperlipidemia and smoking status. These patients were then followed 6 monthly for 2 years to look for the development of diabetic retinopathy.
RESULTS
The mean age of the patients was 50.72±9.29 years and there were 57 (57%) male and 43 (43%) female patients. Majority (82%) of the patients had NIDDM. The mean duration of diabetes was 8.31±6.83 years. 11% of the patients were smoker, 37% were hypertensive, 6% had hyperlipidaemia, 62% had family history of diabetes and 30% had family history of hypertension. At the end of follow-up, 9 (9.0%) patients had diabetic retinopathy. The frequency of diabetic retinopathy increased with increasing age of the patient; however, the difference was statistically insignificant. A comparatively higher frequency of diabetic retinopathy was also seen in patients with IDDM and those with positive family history of diabetes and hypertension yet again, the difference was statistically insignificant. Also, no significant difference was noted among male and female genders and smokers vs. non-smoker. However, the frequency of diabetic retinopathy increased significantly with increasing duration of diabetes. It was also higher among those with hypertension and hyperlipidemia.
CONCLUSION
Higher patient age (≥50 years), increasing duration of diabetes (≥20 years), insulin dependent diabetes mellitus, hypertension, hyperlipidemia, and positive family history of diabetes and hypertension were found to be associated with increased frequency of diabetic retinopathy.
目的
确定高血压、高脂血症、吸烟以及糖尿病和高血压家族史阳性在糖尿病视网膜病变发生发展中的作用。
方法
这项前瞻性队列研究于2014年6月至2016年6月在拉瓦尔品第武装部队病理研究所化学病理科进行，为期2年。通过非概率方便抽样法，在获得书面知情同意后，连续纳入100例无糖尿病视网膜病变体征且血糖控制良好（糖化血红蛋白<6.5%）的糖尿病患者。对他们进行高血压、高脂血症和吸烟状况评估。然后对这些患者每6个月随访一次，持续2年，以观察糖尿病视网膜病变的发生情况。
结果
患者的平均年龄为50.72±9.29岁，其中男性57例（57%），女性43例（43%）。大多数（82%）患者为非胰岛素依赖型糖尿病。糖尿病的平均病程为8.31±6.83年。11%的患者吸烟，37%的患者患有高血压，6%的患者患有高脂血症，62%的患者有糖尿病家族史，30%的患者有高血压家族史。随访结束时，9例（9.0%）患者发生了糖尿病视网膜病变。糖尿病视网膜病变的发生率随患者年龄的增加而升高，但差异无统计学意义。在胰岛素依赖型糖尿病患者以及有糖尿病和高血压家族史阳性的患者中，糖尿病视网膜病变的发生率相对较高，但差异仍无统计学意义。此外，男性和女性以及吸烟者与非吸烟者之间也未发现显著差异。然而，糖尿病视网膜病变的发生率随糖尿病病程的延长而显著增加。在患有高血压和高脂血症的患者中其发生率也较高。
结论
发现患者年龄较大（≥50岁）、糖尿病病程延长（≥20年）、胰岛素依赖型糖尿病、高血压、高脂血症以及糖尿病和高血压家族史阳性与糖尿病视网膜病变的发生率增加有关。
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