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中国人 2 型糖尿病患者眼生物测量参数与糖尿病视网膜病变的相关性。

Association between ocular biometrical parameters and diabetic retinopathy in Chinese adults with type 2 diabetes mellitus.

机构信息

Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, China.

School of Medicine, Sun Yat-sen University, Guangzhou, China.

出版信息

Acta Ophthalmol. 2021 Aug;99(5):e661-e668. doi: 10.1111/aos.14671. Epub 2020 Nov 16.

Abstract

PURPOSE

The influence of myopia and ocular biometry parameters on diabetic retinopathy (DR) needs further clarification. We aimed to investigate the association between ocular biometrical parameters and DR in Chinese people with diabetes mellitus (DM) without any ocular intervention.

METHODS

This cross-sectional study recruited type 2 DM patients with no history of ocular treatment in Guangzhou, China. The ocular biometrical parameters were obtained by Lenstar (LS900, Haag-Streit AG, Koeniz, Switzerland), including corneal diameter, central corneal thickness (CCT), corneal curvature (CC), anterior chamber depth (ACD), lens thickness (LT) and axial length (AL). The lens power and axial length-to-cornea radius ratio (AL/CR ratio) were calculated. Spherical equivalent (SE) was determined by auto-refraction after pupil dilation. Multivariate logistic regression analyses were performed to explore the associations of ocular biometry with any DR and vision threatening DR (VTDR).

RESULTS

A total of 1838 patients were included in the final analysis, involving 1455 (79.2%) patients without DR and 383(20.8%) patients with DR. After adjusting confounding factors, any DR was independently associated with AL (odds ratio (OR) 0.84 per 1 mm increase, 95% confidence interval (CI): 0.74, 0.94) and AL/CR ratio (OR 0.26 per 1 increase, 95%CI: 0.10, 0.70). Similarly, the presence of VTDR was independently related to AL (OR 0.67 per 1 mm increase, 95%CI: 0.54, 0.85) and AL/CR ratio (OR 0.04 per 1 increase, 95%CI: 0.01, 0.25). The lens power may not be significantly correlated with presence of any DR or VTDR. The CC, corneal diameter and refractive status were not significantly correlated with presence of DR or VTDR.

CONCLUSION

Longer AL and higher AL/CR ratio may be protective factors against the occurrence and progression of DR. Further longitudinal studies are warranted to verify if refractive status and AL-associated parameters contribute to the occurrence and progression of DR in type 2 DM.

摘要

目的

近视和眼生物测量参数对糖尿病视网膜病变(DR)的影响仍需进一步阐明。本研究旨在调查未经任何眼部干预的中国糖尿病(DM)患者的眼生物测量参数与 DR 之间的关系。

方法

本横断面研究纳入了在中国广州无眼部治疗史的 2 型 DM 患者。通过 Lenstar(LS900,Haag-Streit AG,Koeniz,瑞士)获取眼生物测量参数,包括角膜直径、中央角膜厚度(CCT)、角膜曲率(CC)、前房深度(ACD)、晶状体厚度(LT)和眼轴长度(AL)。计算晶状体屈光力和眼轴与角膜半径比(AL/CR 比)。瞳孔扩张后自动折射确定等效球镜(SE)。采用多变量逻辑回归分析探讨眼生物测量与任何 DR 和威胁视力的 DR(VTDR)的关系。

结果

共纳入 1838 例患者,最终分析包括 1455 例(79.2%)无 DR 患者和 383 例(20.8%)DR 患者。调整混杂因素后,任何 DR 均与 AL(每增加 1mm 的比值比(OR)为 0.84,95%置信区间(CI):0.74,0.94)和 AL/CR 比(每增加 1 增加的比值比(OR)为 0.26,95%CI:0.10,0.70)独立相关。同样,VTDR 的存在与 AL(每增加 1mm 的比值比(OR)为 0.67,95%CI:0.54,0.85)和 AL/CR 比(每增加 1 增加的比值比(OR)为 0.04,95%CI:0.01,0.25)独立相关。晶状体屈光力与任何 DR 或 VTDR 的发生均无显著相关性。CC、角膜直径和屈光状态与 DR 或 VTDR 的发生均无显著相关性。

结论

较长的 AL 和较高的 AL/CR 比可能是 DR 发生和进展的保护因素。需要进一步的纵向研究来验证屈光状态和 AL 相关参数是否有助于 2 型糖尿病 DR 的发生和进展。

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