Graue-Hernandez Enrique O, Rivera-De-La-Parra David, Hernandez-Jimenez Sergio, Aguilar-Salinas Carlos A, Kershenobich-Stalnikowitz David, Jimenez-Corona Aida
Departamento de Córnea y Cirugía Refractiva, Instituto de Oftalmología Fundación Conde de Valenciana IAP, Ciudad de México, México.
Instituto de Oftalmología Fundación Conde de Valenciana IAP, Ciudad de México, México.
BMJ Open Ophthalmol. 2020 Mar 10;5(1):e000304. doi: 10.1136/bmjophth-2019-000304. eCollection 2020.
To determine the prevalence of diabetic retinopathy (DR) and diabetic macular oedema (DME) and their associated risk factors in patients recently diagnosed with type 2 diabetes.
We carried out a cross-sectional study from April 2014 to August 2017. We included patients aged ≥18 years. Diabetes was defined as fasting plasma glucose of >7.8 mmol/L or 2-hour postload plasma glucose of >11.1 mmol/L. Non-mydriatic fundus examination with a digital-fundus camera was performed. Three images centred in the macula, optic disc and temporal to the macula were obtained and graded according to the Scottish Scale Classification of Diabetic Retinopathy.
1232 patients (mean age 51.5 years) with a diabetes duration of 0-5 years were examined. Age-adjusted and sex-adjusted prevalence of DR and DME was 17.4% (95% CI 15.3% to 19.6%) and 6.6% (95% CI 5.4% to 8.2%), respectively. DR was associated with diabetes duration (OR per year=1.20, p<0.001), haemoglobin A1c (HbA1c) from 7.0 to 8.9 (OR=2.19, p<0.001), HbA1c≥9 (OR=2.98, p<0.001) and systolic blood pressure (SBP) (OR=1.16 per 5 mm Hg, p<0.001). DME was associated with diabetes duration (OR per year=1.26, p<0.01), HbA1c from 7.0 to 8.9 (OR=2.26, p<0.05), HbA1c≥9 (OR=2.38, p<0.01), SBP (OR per mm Hg=1.15, p<0.001) and albuminuria (OR=2.45, p<0.01).
Our study contributes to the evidence of progressive increase in DR and DME risk in early stages of diabetes, supporting the urgent need for early screening.
确定近期诊断为2型糖尿病患者的糖尿病视网膜病变（DR）和糖尿病性黄斑水肿（DME）的患病率及其相关危险因素。
我们在2014年4月至2017年8月期间开展了一项横断面研究。纳入年龄≥18岁的患者。糖尿病定义为空腹血糖>7.8 mmol/L或餐后2小时血糖>11.1 mmol/L。使用数码眼底相机进行非散瞳眼底检查。获取以黄斑、视盘和黄斑颞侧为中心的三张图像，并根据糖尿病视网膜病变的苏格兰量表分类进行分级。
对1232例糖尿病病程为0至5年（平均年龄51.5岁）的患者进行了检查。经年龄和性别调整后，DR和DME的患病率分别为17.4%（95%CI 15.3%至19.6%）和6.6%（95%CI 5.4%至8.2%）。DR与糖尿病病程（每年OR = 1.20，p<0.001）、糖化血红蛋白（HbA1c）7.0至8.9（OR = 2.19，p<0.001）、HbA1c≥9（OR = 2.98，p<0.001）以及收缩压（SBP）（每5 mmHg的OR = 1.16，p<0.001）相关。DME与糖尿病病程（每年OR = 1.26，p<0.01）、HbA1c 7.0至8.9（OR = 2.26，p<0.05）、HbA1c≥9（OR = 2.38，p<0.01）、SBP（每mmHg的OR = 1.15，p<0.001）以及蛋白尿（OR = 2.45，p<0.01）相关。
我们的研究为糖尿病早期DR和DME风险逐渐增加的证据提供了补充，支持了早期筛查的迫切需求。
