埃塞俄比亚西北部德布雷塔博尔综合医院成年糖尿病患者中威胁视力的糖尿病视网膜病变及相关危险因素
Sight-threatening Diabetic Retinopathy and Associated Risk Factors Among Adult Diabetes Patients at Debre Tabor General Hospital, Northwest Ethiopia.
作者信息
Alemu Mersha Getasew, Tsegaw Woredekal Asamere, Tilahun Tesfaw Matyas
机构信息
Department of Optometry, School of Medicine, University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia.
Department of Ophthalmology, School of Medicine, University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia.
出版信息
Clin Ophthalmol. 2020 Dec 30;14:4561-4569. doi: 10.2147/OPTH.S285606. eCollection 2020.
BACKGROUND
People with diabetes have an increased risk of developing sight-threatening conditions. Sight threatening diabetic retinopathy (STDR) is an advanced microvascular of complication of diabetes on the eye. It remains one of the leading causes of preventable blindness among working age adults around the world. There is a paucity of evidence on the prevalence of STDR and its associated factors in Ethiopia, particularly in the study area. Therefore, the aim of our study was to determine the prevalence of STDR and its associated factors among adult diabetes patients at Debre Tabor General Hospital (DTGH), Northwest Ethiopia.
MATERIALS AND METHODS
An institution-based cross-sectional study was conducted on 306 diabetes patients at Debre Tabor General Hospital with systematic random sampling technique. Semi-structured questionnaire, document review and physical examination were applied to collect the data. Binary and multivariable logistic regression model were used to identify associated factors for STDR.
RESULTS
The majority of the participants 163 (53.3%) were type 1 diabetes (T1DM) and the mean age of T1 and T2 DM participants was 34.5 (12.8) and 58.7 (10.7) years respectively. The prevalence of STDR was 15.3% (95%CI: 9.6%-20.9%) and 11.9% (6.6-17.5) in T1DM and T2DM, respectively. Low family monthly income (adjusted odds ratio (AOR)=4.4, 95%CI: 1.05-18.40) among T2DM, longer duration of diabetes (AOR=10.9, 95%CI: 2.94-40.4) among T1DM (AOR=3.54, 95CI: 1.06-11.8) among T2DM and poor glycemic control (AOR=3.93, 95%CI: 1.06-14.5) and hypertension (AOR=5.86, 95%CI: 1.20-28.6) among T1DM and BMI (AOR=4.79, 95%CI: 1.35-17.00) among T2DM were significantly associated with STDR.
CONCLUSION AND RECOMMENDATION
The prevalence of STDR was high. Low family monthly income, longer duration of diabetes, poor glycemic control, hypertension and obesity were positively associated with STDR. Early screening of STDR and improving diabetes self management in all diabetes patients were recommended.
背景
糖尿病患者发生威胁视力情况的风险增加。威胁视力的糖尿病视网膜病变（STDR）是糖尿病眼部微血管的一种晚期并发症。它仍是全球劳动年龄成年人可预防失明的主要原因之一。在埃塞俄比亚，特别是在研究地区，关于STDR的患病率及其相关因素的证据很少。因此，我们研究的目的是确定埃塞俄比亚西北部德布雷塔博尔综合医院（DTGH）成年糖尿病患者中STDR的患病率及其相关因素。
材料与方法
采用系统随机抽样技术，对德布雷塔博尔综合医院的306例糖尿病患者进行了一项基于机构的横断面研究。应用半结构化问卷、文件审查和体格检查收集数据。采用二元和多变量逻辑回归模型确定STDR的相关因素。
结果
大多数参与者163例（53.3%）为1型糖尿病（T1DM），T1DM和T2DM参与者的平均年龄分别为34.5（12.8）岁和58.7（10.7）岁。T1DM和T2DM中STDR的患病率分别为15.3%（95%CI：9.6%-20.9%）和11.9%（6.6-17.5）。T2DM患者家庭月收入低（调整优势比（AOR）=4.4，95%CI：1.05-18.40），T1DM患者糖尿病病程长（AOR=10.9，95%CI：2.94-40.4），T2DM患者糖尿病病程长（AOR=3.54，95CI：1.06-11.8），T1DM患者血糖控制差（AOR=3.93，95%CI：1.06-14.5）和高血压（AOR=5.86，95%CI：1.20-28.6），T2DM患者体重指数（AOR=4.79，95%CI：1.35-17.00）与STDR显著相关。
结论与建议
STDR患病率较高。家庭月收入低、糖尿病病程长、血糖控制差、高血压和肥胖与STDR呈正相关。建议对所有糖尿病患者进行STDR早期筛查并改善糖尿病自我管理。
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