血糖变异性对 2 型糖尿病患者糖尿病视网膜病变进展的影响。
EFFECTS OF GLYCEMIC VARIABILITY ON THE PROGRESSION OF DIABETIC RETINOPATHY AMONG PATIENTS WITH TYPE 2 DIABETES.
机构信息
Department of Ophthalmology, Sanggye Paik Hospital, Inje University, Seoul, Korea; and.
Department of Internal Medicine, Sanggye Paik Hospital, Cardiovascular and Metabolic Disease Center, Inje University, Seoul, Korea.
出版信息
Retina. 2021 Jul 1;41(7):1487-1495. doi: 10.1097/IAE.0000000000003049.
PURPOSE
To evaluate the effects of glycemic variability on the progression of diabetic retinopathy (DR) among individuals with Type 2 diabetes and to test the hypothesis that consistent glycemic control delays the progression of DR.
METHODS
This retrospective study included 1,125 participants with a follow-up period of more than 5 years and more than 20 glucose laboratory test results. The hazard ratio of ≥3 steps of progression on the Early Treatment Diabetic Retinopathy Study person scale and progression to proliferative DR were assessed.
RESULTS
An increase in the HbA1c SD was associated with a higher risk of ≥3 step progression (P < 0.001) and progression to proliferative DR (P < 0.001). Not only mean HbA1c, but also HbA1c SD was associated with a lower risk of ≥3 steps of progression (P < 0.001), and progression to proliferative DR (P < 0.001).
CONCLUSION
Achievable and consistent glycemic control may contribute to the delay in DR progression.
CLINICAL TRIAL REGISTRATION NUMBER
Institutional review board of Inje University (No. 202003014).
目的
评估血糖变异性对 2 型糖尿病患者糖尿病视网膜病变（DR）进展的影响，并检验持续血糖控制可延缓 DR 进展的假说。
方法
本回顾性研究纳入了 1125 名随访时间超过 5 年且至少有 20 次血糖实验室检测结果的参与者。评估了早期治疗糖尿病视网膜病变研究个体量表上≥3 级进展和进展为增殖性 DR 的风险比。
结果
HbA1c SD 的增加与≥3 级进展（P<0.001）和进展为增殖性 DR（P<0.001）的风险增加相关。不仅平均 HbA1c，HbA1c SD 也与≥3 级进展（P<0.001）和进展为增殖性 DR（P<0.001）的风险降低相关。
结论
可实现和持续的血糖控制可能有助于延缓 DR 的进展。
临床试验注册号
仁济大学机构审查委员会（编号：202003014）。
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