Neonatal Intensive Care Unit, Pediatric Department, Jagiellonian University, Collegium Medicum, Krakow, Poland.
Retina. 2021 Apr 1;41(4):711-717. doi: 10.1097/IAE.0000000000002949.
To assess the association between glycemic variability (GV) and Type 1 retinopathy of prematurity (ROP) in infants with birth weights of less than 1,251 g.
A case-control study of infants with birth weights of less than 1,251 g who developed Type 1 ROP (n = 20) was conducted. Controls had a less severe ROP or no eye disease and were individually matched for gestational age and birth weight (n = 40). Odds ratios of ROP were calculated based on multiple factors including oxygen exposure, respiratory support, incidence of hyperglycemia, and GV. For glucose measurements, a continuous glucose monitoring system was used.
There were no significant differences in gender, antenatal steroid administration, severity of illness, and Apgar score. Univariate analyses suggest increased risk for the development of Type 1 ROP based on incidence of intraventricular hemorrhage Grade 3 or 4 (P = 0.048), duration of oxygen exposure (P = 0.003), incidence of hyperglycemia over 150 mg/dL (P = 0.01), and GV according to significantly higher SD (P = 0.002), coefficient of variation (P = 0.001), and mean amplitude of glucose excursion (P = 0.008). Using a multiple regression model, increased risk of Type 1 ROP was only found to be associated with duration of oxygen exposure and higher GV.
Our study demonstrates a relationship between GV and the development of severe ROP.
评估血糖变异性（GV）与出生体重小于 1251g 的早产儿 1 型视网膜病变（ROP）之间的关系。
对患有 1 型 ROP（n=20）的出生体重小于 1251g 的婴儿进行病例对照研究。对照组的 ROP 程度较轻或没有眼部疾病，且在胎龄和出生体重方面与病例组相匹配（n=40）。基于氧暴露、呼吸支持、高血糖发生率和 GV 等多种因素计算 ROP 的比值比。对于葡萄糖测量，使用连续血糖监测系统。
两组在性别、产前类固醇使用、疾病严重程度和 Apgar 评分方面无显著差异。单因素分析表明，脑室出血 3 或 4 级（P=0.048）、氧暴露时间（P=0.003）、高血糖发生率（P=0.01）、SD （P=0.002）、变异系数（P=0.001）和血糖波动幅度（P=0.008）显著升高与 1 型 ROP 发生风险增加有关。采用多因素回归模型，仅发现氧暴露时间和较高的 GV 与 1 型 ROP 的发生风险增加相关。
本研究表明 GV 与严重 ROP 的发生有关。
