Lv Xinlu, Ran Xi, Chen Xiangjun, Luo Ting, Hu Jinbo, Wang Yue, Liu Zhiping, Zhen Qianna, Liu Xiurong, Zheng Li, Tang Ying, Zhao Qinying, Han Shichao, Zhou Yangmei, Luo Wenjin, Yang Lina, Li Qifu, Wang Zhihong
Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing.
Department of Endocrinology, The Affiliated Yanan Hospital of Kunming Medical University, Kunming, Yunnan, China.
Medicine (Baltimore). 2020 May;99(19):e20189. doi: 10.1097/MD.0000000000020189.
We aim to explore the relationship between early-onset diabetes and proliferative diabetic retinopathy (PDR) in type 2 diabetes mellitus (T2DM) patients with microalbuminuria.A total of 461 T2DM patients with microalbuminuria were enrolled. Subjects were defined as early-onset or late-onset based on the age at which they were diagnosed with diabetes (<40 and ≥40 years, respectively). Medical history, anthropometry, and laboratory indicators were documented. PDR was defined as the presence of any of the following changes on fundus photography: neovascularization, vitreous hemorrhage, or preretinal hemorrhage.The prevalence of PDR was 6-fold higher in patients with early-onset than late-onset T2DM [(6.1% vs 1.0%), P = .004]. Univariate correlation analysis showed that early-onset diabetes, use of oral hypoglycemic drugs, and insulin therapy were risk factors for PDR. In multivariate logistic analysis, patients with early-onset diabetes exhibited a 7.00-fold [(95% confidence interval 1.40-38.26), P = .019] higher risk of PDR than subjects with late-onset diabetes after adjusting for sex; T2DM duration; systolic blood pressure; total triglyceride; glycated hemoglobin; insulin therapy; and the use of oral hypoglycemic drugs, antihypertensive drugs, and lipid-lowering drugs.In T2DM patients with microalbuminuria, early-onset diabetes is an independent risk factor for the development of PDR.
我们旨在探讨微量白蛋白尿的2型糖尿病（T2DM）患者中早发型糖尿病与增殖性糖尿病视网膜病变（PDR）之间的关系。共纳入461例微量白蛋白尿的T2DM患者。根据糖尿病诊断年龄（分别为<40岁和≥40岁）将受试者定义为早发型或晚发型。记录病史、人体测量学指标和实验室指标。PDR定义为眼底照相出现以下任何一种改变：新生血管形成、玻璃体积血或视网膜前出血。早发型T2DM患者的PDR患病率比晚发型高6倍[（6.1%对1.0%），P = 0.004]。单因素相关性分析显示，早发型糖尿病、口服降糖药的使用和胰岛素治疗是PDR的危险因素。在多因素逻辑回归分析中，校正性别、T2DM病程、收缩压、总甘油三酯、糖化血红蛋白、胰岛素治疗以及口服降糖药、抗高血压药和降脂药的使用后，早发型糖尿病患者发生PDR的风险比晚发型糖尿病患者高7.00倍[（95%置信区间1.40 - 38.26），P = 0.019]。在微量白蛋白尿的T2DM患者中，早发型糖尿病是发生PDR的独立危险因素。
