Faculty of Medicine, Porto University, Porto, Portugal.
Department of Ophthalmology, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal.
Endocrine. 2019 Nov;66(2):201-209. doi: 10.1007/s12020-019-02047-z. Epub 2019 Aug 12.
Age at diagnosis of type 1 diabetes (DM1) has been implied as an important factor associated with the development of the microvascular complications. Our aim was to identify factors associated with prevalent diabetic retinopathy (DR) and proliferative diabetic retinopathy (PDR) in DM1 people with early and late-onset.
We reviewed medical records from all DM1 people from the reference area of a tertiary center (about 340,000 persons). Univariate and multivariate logistic regression were used to assess the relationship between potential risk factors (sociodemographic, diabetes-related, co-morbidities, and laboratory parameters) and prevalent DR/PDR. We performed an analysis comparing patients diagnosed before (early-onset) and after (late-onset) 18 years of age.
We included 140 patients in early-onset DM1 group and 169 in late-onset DM1 group. Longer duration of diabetes and HbA1c remained associated with prevalent DR in both groups after adjusting for potential risk factors. Nephropathy was associated with prevalent DR in the late-onset group but not in the early-onset group. Peripheral neuropathy remained associated with prevalent PDR when modeled together in the multivariate model. High BMI demonstrated a significative association with PDR in early but not in the late-onset DM1 group.
Although previous reports suggest that age at DM1 diagnosis may have a role in DR prevalence, the risk factors for DR in early and late-onset DM1 were similar for both groups. Duration of disease and lifelong metabolic control were the major predictors for DR in both groups. Nephropathy was associated with DR in patients with late-onset disease. Neuropathy was associated with PDR occurrence in both groups. BMI was associated with PDR early-onset DM1 group.
1 型糖尿病（DM1）的发病年龄被认为是与微血管并发症发生相关的重要因素。我们的目的是确定与早发和晚发 DM1 患者中常见的糖尿病视网膜病变（DR）和增殖性糖尿病视网膜病变（PDR）相关的因素。
我们回顾了来自三级中心参考区域的所有 DM1 患者的病历（约 340000 人）。使用单变量和多变量逻辑回归来评估潜在危险因素（社会人口统计学、糖尿病相关、合并症和实验室参数）与普遍存在的 DR/PDR 之间的关系。我们进行了一项分析，比较了诊断年龄在 18 岁之前（早发）和之后（晚发）的患者。
我们纳入了 140 例早发 DM1 组和 169 例晚发 DM1 组。在调整了潜在危险因素后，两组中糖尿病病程和 HbA1c 较长与普遍存在的 DR 相关。肾病与晚发组的普遍存在的 DR 相关，但与早发组无关。在多变量模型中同时建模时，周围神经病变与普遍存在的 PDR 相关。高 BMI 与早发 DM1 组的 PDR 有显著关联，但与晚发 DM1 组无关。
尽管先前的报告表明 DM1 诊断时的年龄可能在 DR 患病率中起作用，但早发和晚发 DM1 患者的 DR 危险因素在两组中相似。疾病持续时间和终身代谢控制是两组中 DR 的主要预测因素。肾病与晚发疾病患者的 DR 相关。神经病变与两组的 PDR 发生相关。BMI 与早发 DM1 组的 PDR 相关。
