埃塞俄比亚西南部糖尿病视网膜病变的决定因素：基于医疗机构的病例对照研究。
Determinants of diabetic retinopathy in Southwest Ethiopia: a facility-based case-control study.
机构信息
Nekemte College of Health Sciences, Nekemte, Ethiopia.
Department of Epidemiology, Institute of Health, Jimma University, Jimma, Ethiopia.
出版信息
BMC Public Health. 2020 Apr 15;20(1):503. doi: 10.1186/s12889-020-08652-2.
BACKGROUND
Diabetic Retinopathy is one of the serious complications patients' diabetic patients suffer from. Little is known about which risk factors are associated with this complication. The aim of this study was therefore to identify determinants of Diabetic Retinopathy in Jimma University Medical Center.
METHODS
A facility-based case-control study was conducted. Cases were Diabetic patients with diabetic retinopathy and who were on follow up at the Jimma University Medical Center while controls were Diabetic patients but free of diabetic retinopathy and who were on follow up at the Jimma University Medical Center. Cases and controls were identified and 311 of them were recruited using systematic random sampling. Data were entered into the Epi-Data version 4.1 and analyzed using SPSS Version 20. Binary Logistic regression analysis was conducted to identify determinants of diabetic retinopathy.
RESULT
A total of 106 cases and 205 controls diabetic participated in the study. Being ≥60 years of age (AOR = 5.04,95%CI: 1.83,13.87),being illiterate (AOR = 7.17, 95% CI: 2.61,19.7), poor adherence to medication (AOR =3: 95% CI: 1.29,6.95),having high systolic blood pressure (AOR = 3.38:95% CI: 1.26,9.05), having family history of Diabetes Mellitus (AOR = 3.95: 95% CI: 1.64,9.54), having other micro vascular complications (AOR = 3.76,95% CI: 1.33,10.66), poor glycemic control (AOR = 9.08, 95%CI: 3.7,22.29), poor cholesterol control (AOR = 0.21, 95%CI: 0.08,0.51) and being anaemic (AOR = 2.8, 95%CI: 1.05,7.47) were the independent determinants of diabetic retinopathy.
CONCLUSION
This study found that poor adherence to medication, being at the age of 60 years and above, being illiterate patients, having high systolic blood pressure, having a family history of Diabetes Mellitus, having other micro vascular complication, poor glycemic control, poor cholesterol control and being anemic patient were the independent determinants of diabetic retinopathy. Therefore, more attention should be given to older age and illiterate patients. Giving more emphasis for patients poorly adhered to anti-diabetic medications and giving advice for diabetic patients with high systolic blood pressure to follow their blood pressure regularly are also vital. Diabetic patients should also control their Blood sugar and blood cholesterol levels to prevent diabetic retinopathy or reduce its further complications.
背景
糖尿病视网膜病变是糖尿病患者的严重并发症之一。目前尚不清楚哪些危险因素与这种并发症有关。因此，本研究的目的是确定在吉马大学医学中心发生糖尿病视网膜病变的决定因素。
方法
这是一项基于医疗机构的病例对照研究。病例为在吉马大学医学中心接受随访的患有糖尿病视网膜病变的糖尿病患者，而对照为在吉马大学医学中心接受随访的无糖尿病视网膜病变的糖尿病患者。使用系统随机抽样法确定病例和对照，并招募了 311 名病例和对照。将数据录入 Epi-Data 版本 4.1 并使用 SPSS 版本 20 进行分析。使用二元逻辑回归分析确定糖尿病视网膜病变的决定因素。
结果
共有 106 名病例和 205 名对照糖尿病患者参加了这项研究。年龄≥60 岁（AOR=5.04，95%CI：1.83，13.87）、文盲（AOR=7.17，95%CI：2.61，19.7）、药物依从性差（AOR=3：95%CI：1.29，6.95）、收缩压高（AOR=3.38：95%CI：1.26，9.05）、有糖尿病家族史（AOR=3.95：95%CI：1.64，9.54）、有其他微血管并发症（AOR=3.76，95%CI：1.33，10.66）、血糖控制不佳（AOR=9.08，95%CI：3.7，22.29）、胆固醇控制不佳（AOR=0.21，95%CI：0.08，0.51）和贫血（AOR=2.8，95%CI：1.05，7.47）是糖尿病视网膜病变的独立决定因素。
结论
本研究发现，药物依从性差、年龄在 60 岁及以上、文盲患者、收缩压高、有糖尿病家族史、有其他微血管并发症、血糖控制不佳、胆固醇控制不佳和贫血患者是糖尿病视网膜病变的独立决定因素。因此，应更加关注老年和文盲患者。对于药物依从性差的患者给予更多关注，并建议高血压的糖尿病患者定期监测血压，这也至关重要。糖尿病患者还应控制血糖和血胆固醇水平，以预防糖尿病视网膜病变或减少其进一步的并发症。
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