School of Public Health, Shanghai Jiao Tong University, Shanghai, China.
School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Int J Health Plann Manage. 2019 Jul;34(3):998-1012. doi: 10.1002/hpm.2870. Epub 2019 Aug 1.
To determine the incidence, progression, and regression rates of diabetic retinopathy (DR), as well as their associated factors, in Chinese type 2 diabetic patients.
Diabetic patients who participated in a previous survey were recruited for a 1-year follow-up study. Nonmydriatic fundus photographs were acquired to assess the severity of DR as per the International Clinical Diabetic Retinopathy Disease Severity Scale (2002). Factors that potentially influence DR outcomes, including its incidence, progression, and regression, were identified via statistical analyses.
We initially recruited 2453 subjects, among whom 2331 were followed and included in the final analysis. The incidences of new and progressed (ie, ≥2 scale steps) DR were 10.6% and 6.1%, respectively. Moreover, 7.3% of patients with established DR at baseline experienced complete regression. Multivariate logistic regression analysis revealed that high glycosylated haemoglobin (HbA1c) (odds ratio [OR] = 1.50, P = .021) and hyperlipidaemia (OR = 1.46, P = .025) were independent predictors of DR development, high HbA1c (OR = 4.16, P = .027) and macroalbuminuria (OR = 5.60, P = .010) predicted DR progression, and low HbA1c (OR = 0.20, P = .001) and low triglyceride levels (OR = 0.34, P = .026) were associated with DR regression.
Albumin and HbA1c levels should be closely monitored as signs of progressive retinal damage in diabetic subjects. Optimized control of glucose and triglyceride levels is vital for reducing the incidence of DR or promoting its regression in afflicted patients.
确定中国 2 型糖尿病患者糖尿病视网膜病变（DR）的发生率、进展率和消退率及其相关因素。
招募参加先前调查的糖尿病患者进行为期 1 年的随访研究。使用免散瞳眼底照相评估 DR 的严重程度，根据国际临床糖尿病视网膜病变疾病严重程度分级（2002 年）。通过统计分析确定可能影响 DR 结局的因素，包括其发生率、进展和消退。
我们最初招募了 2453 名受试者，其中 2331 名被随访并纳入最终分析。新发和进展性（即≥2 个分级阶段）DR 的发生率分别为 10.6%和 6.1%。此外，基线时有明确 DR 的患者中有 7.3%完全消退。多变量逻辑回归分析显示，高糖化血红蛋白（HbA1c）（比值比[OR] = 1.50，P =.021）和高脂血症（OR = 1.46，P =.025）是 DR 发生的独立预测因素，高 HbA1c（OR = 4.16，P =.027）和大量白蛋白尿（OR = 5.60，P =.010）预测 DR 进展，低 HbA1c（OR = 0.20，P =.001）和低三酰甘油水平（OR = 0.34，P =.026）与 DR 消退相关。
白蛋白和 HbA1c 水平应密切监测，作为糖尿病患者视网膜进行性损害的标志。优化血糖和三酰甘油水平的控制对于降低 DR 的发生率或促进受影响患者的消退至关重要。
