中心性肥胖与中国人群糖尿病视网膜病变有关联吗？一项探索性研究。

Is central obesity associated with diabetic retinopathy in Chinese individuals? An exploratory study.

作者信息

Zhou Jian-Bo, Yuan Jing, Tang Xing-Yao, Zhao Wei, Luo Fu-Qiang, Bai Lu, Li Bei, Cong Jia, Qi Lu, Yang Jin-Kui

机构信息

Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.

Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States.

出版信息

J Int Med Res. 2019 Nov;47(11):5601-5612. doi: 10.1177/0300060519874909. Epub 2019 Sep 23.

OBJECTIVE

To our knowledge, the independent association between central obesity, defined by waist circumference (WC) or waist-to-hip ratio (WHR), and diabetic retinopathy (DR) remains unknown in Chinese individuals.

METHOD

The study was conducted in two stages. First, the relationship between WC or WHR and DR was estimated in a case-control set (DR vs. non-DR) for the whole population before and after propensity score matching. Subsequently, a systematic review and meta-analysis was performed on evidence from the literature to validate the relationship.

RESULTS

Of 511 eligible patients, DR (N = 156) and non-DR (N = 156) patients with similar propensity scores were included in the propensity score matching analyses. Central obesity (defined by WC) was associated with risk of DR (odds ratio [OR] 1.07, 95% confidence interval [95% CI] (1.03–1.10). The meta-analysis showed that central obesity significantly increased the risk of DR by 12% (OR 1.12, 95% CI 1.02–1.22). Analysis of data from 18 studies showed a significant association between continuous body mass index and risk of proliferative DR (OR 0.95, 95% CI 0.93–0.98; I = 50%).

CONCLUSION

Central obesity, particularly as defined by WC, is associated with the risk of DR in the Chinese population.

目的

据我们所知，在中国人群中，由腰围（WC）或腰臀比（WHR）定义的中心性肥胖与糖尿病视网膜病变（DR）之间的独立关联尚不清楚。

方法

该研究分两个阶段进行。首先，在倾向得分匹配前后的全人群病例对照组（DR组与非DR组）中评估WC或WHR与DR之间的关系。随后，对文献证据进行系统评价和荟萃分析以验证这种关系。

结果

在511例符合条件的患者中，倾向得分匹配分析纳入了倾向得分相似的DR患者（N = 156）和非DR患者（N = 156）。中心性肥胖（由WC定义）与DR风险相关（比值比[OR] 1.07，95%置信区间[95%CI]为(1.03 - 1.10)）。荟萃分析表明，中心性肥胖使DR风险显著增加12%（OR 1.12，95%CI 1.02 - 1.22）。对18项研究数据的分析显示，连续的体重指数与增殖性DR风险之间存在显著关联（OR 0.95，95%CI 0.93 - 0.98；I² = 50%）。