分析新诊断 2 型糖尿病患者糖尿病视网膜病变相关因素的横断面研究。
Analysis of factors related to diabetic retinopathy in patients with newly diagnosed type 2 diabetes: a cross-sectional study.
机构信息
NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University, Chu Hsien-I Memorial Hospital, Tianjin Institute of Endocrinology, Tianjin, China.
Metabolic Disease Management Center, Tianjin 4th Central Hospital, The 4th Central Hospital Affiliated to Nankai University, The 4th Center Clinical College of Tianjin Medical University, Tianjin, China.
出版信息
BMJ Open. 2020 Feb 10;10(2):e032095. doi: 10.1136/bmjopen-2019-032095.
AIM
To investigate the related factors of diabetic retinopathy (DR) and explore the correlation between smoking and DR in patients with newly diagnosed type 2 diabetes mellitus (T2DM).
DESIGN
A single-centre cross-sectional study.
SETTING
Tianjin 4th Central Hospital.
PARTICIPANTS
Patients with newly diagnosed T2DM who visited the outpatient department of the hospital from December 2018 to April 2019.
METHODS
A total of 947 patients were enrolled in the study. They were divided into two groups according to whether they were diagnosed with DR (diabetic retinopathy group, DR group; non-diabetic retinopathy group, NDR group). The smoking index (SI) was calculated to assess smoking status. Factors such as sex, age, hypertension, T2DM diagnosed age, family history of diabetes, drinking history, haemoglobin A1c (HbA1c), body mass index (BMI) and smoking status were compared between the two groups. Logistic regression was used to analyse the relationship between DR and the above factors.
RESULTS
There was no statistically significant difference between the two groups in sex, age, hypertension, DM diagnosed age, family history of diabetes, drinking history and HbA1c. BMI was significantly higher in DR patients (27.7±4.2 vs 26.7±4.4, p=0.004). Smoking status was also different between the two groups (χ=6.350, p=0.042). BMI was shown to be a related factor for DR in patients with newly diagnosed diabetes (OR=0.592, p=0.004). When BMI was ≥28 kg/m, heavy smoking was significantly associated with DR (OR=2.219, p=0.049), and there was a negative correlation between DR and the age of diagnosis of diabetes ≥60 years (OR=0.289, p=0.009).
CONCLUSIONS
Heavy smoking was an important related factor for DR in patients with newly diagnosed diabetes mellitus when BMI was ≥28 kg/m. Delaying the age of diabetes might prevent the occurrence of DR. To elucidate the correlation, long-term cohort studies with large samples are needed.
目的
探讨糖尿病视网膜病变（DR）的相关因素，并分析初诊 2 型糖尿病（T2DM）患者中吸烟与 DR 的相关性。
设计
单中心横断面研究。
地点
天津市第四中心医院。
对象
于 2018 年 12 月至 2019 年 4 月在医院门诊就诊的初诊 T2DM 患者。
方法
共纳入 947 例患者，根据是否诊断为 DR 将其分为两组：糖尿病视网膜病变组（DR 组）和非糖尿病视网膜病变组（NDR 组）。计算吸烟指数（SI）以评估吸烟状况。比较两组患者的性别、年龄、高血压、T2DM 诊断年龄、糖尿病家族史、饮酒史、糖化血红蛋白（HbA1c）、体质量指数（BMI）和吸烟状况等因素。采用 logistic 回归分析 DR 与上述因素的关系。
结果
两组患者在性别、年龄、高血压、DM 诊断年龄、糖尿病家族史、饮酒史和 HbA1c 方面比较，差异均无统计学意义（均 P>0.05）。DR 患者 BMI 明显高于 NDR 患者[（27.7±4.2）kg/m²比（26.7±4.4）kg/m²，P=0.004]。两组患者吸烟状况也不同（χ²=6.350，P=0.042）。BMI 是初诊糖尿病患者发生 DR 的相关因素（OR=0.592，P=0.004）。当 BMI≥28 kg/m²时，重度吸烟与 DR 显著相关（OR=2.219，P=0.049），糖尿病诊断年龄≥60 岁与 DR 呈负相关（OR=0.289，P=0.009）。
结论
当 BMI≥28 kg/m²时，重度吸烟是初诊 T2DM 患者发生 DR 的重要相关因素，延迟糖尿病的发病年龄可能有助于预防 DR 的发生。为了阐明两者之间的相关性，需要进行长期、大样本的队列研究。
Zotero 插件