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中国南方 2 型糖尿病患者糖尿病视网膜病变和糖尿病黄斑水肿与肾功能的关系:一项单中心观察性研究。

Association of diabetic retinopathy and diabetic macular oedema with renal function in southern Chinese patients with type 2 diabetes mellitus: a single-centre observational study.

机构信息

Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangzhou, China.

Shantou University Medical College, Shantou, China.

出版信息

BMJ Open. 2019 Sep 6;9(9):e031194. doi: 10.1136/bmjopen-2019-031194.

Abstract

BACKGROUND AND OBJECTIVES

The association of diabetic retinopathy (DR) and diabetic macular oedema (DME) with renal function in southern Chinese patients with diabetes is poorly understood. So we aimed to study the correlation between stage of DR and DME with stage of estimated glomerular filtration rate (eGFR) and stage of urine albumin-to-creatinine ratio (UACR), and to explore the systemic risk factors for DR and DME.

DESIGN AND SETTING

This single-centre retrospective observational study was conducted from December 2017 to November 2018.

PARTICIPANTS

413 southern Chinese patients with type 2 diabetes mellitus.

OUTCOME MEASURES

The correlations between stage of DR and DME with stage of eGFR/UACR were assessed by Spearman's or χ² analyses and represented with histograms. Risk factors associated with the occurrence of DR and DME were performed by logistic regression and represented with nomograms.

RESULTS

Stage of DR had a positive correlation with stage of eGFR (r=0.264, p<0.001) and stage of UACR (r=0.542, p<0.001). With the stage of eGFR/UACR being more severe, the prevalence of DME became higher as well (both p<0.001). The risk factors for DR were DM duration (OR 1.072; 95% CI 1.032 to 1.114; p<0.001), stage of UACR (OR 2.001; 95% CI 1.567 to 2.555; p<0.001) and low-density lipoprotein (LDL) (OR 1.301; 95% CI 1.139 to 1.485; p<0.001), while risk factors for DME were stage of UACR (OR 2.308; 95% CI 1.815 to 2.934; p<0.001) and LDL (OR 1.460; 95% CI 1.123 to 1.875; p=0.008).

CONCLUSIONS

Among southern Chinese patients, stage of DR and DME were positively correlated with renal function, while stage of UACR performed a better relevance than stage of eGFR.

摘要

背景与目的

在中国南方的糖尿病患者中,糖尿病视网膜病变(DR)和糖尿病黄斑水肿(DME)与肾功能之间的关系尚不清楚。因此,我们旨在研究 DR 和 DME 分期与估计肾小球滤过率(eGFR)和尿白蛋白与肌酐比值(UACR)分期之间的相关性,并探讨 DR 和 DME 的系统性危险因素。

设计与设置

这是一项单中心回顾性观察研究,于 2017 年 12 月至 2018 年 11 月进行。

参与者

413 名中国南方 2 型糖尿病患者。

观察指标

采用 Spearman 或 χ²分析评估 DR 和 DME 分期与 eGFR/UACR 分期之间的相关性,并以直方图表示。采用逻辑回归分析 DR 和 DME 发生的相关危险因素,并以列线图表示。

结果

DR 分期与 eGFR(r=0.264,p<0.001)和 UACR(r=0.542,p<0.001)呈正相关。随着 eGFR/UACR 分期的加重,DME 的患病率也随之升高(均 p<0.001)。DR 的危险因素是糖尿病病程(OR 1.072;95%CI 1.032 至 1.114;p<0.001)、UACR 分期(OR 2.001;95%CI 1.567 至 2.555;p<0.001)和低密度脂蛋白(LDL)(OR 1.301;95%CI 1.139 至 1.485;p<0.001),而 DME 的危险因素是 UACR 分期(OR 2.308;95%CI 1.815 至 2.934;p<0.001)和 LDL(OR 1.460;95%CI 1.123 至 1.875;p=0.008)。

结论

在中国南方患者中,DR 和 DME 分期与肾功能呈正相关,而 UACR 分期比 eGFR 分期相关性更好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c35b/6731866/2bf00573128d/bmjopen-2019-031194f01.jpg

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