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糖尿病视网膜病变微量白蛋白尿与其他可改变的危险因素的关系。

Relationship between diabetic retinopathy microalbuminuria and other modifiable risk factors.

机构信息

Hamdard Institute of Medical Sciences and Research, New Delhi, India.

Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, India.

出版信息

Prim Care Diabetes. 2021 Jun;15(3):567-570. doi: 10.1016/j.pcd.2021.01.012. Epub 2021 Feb 4.

Abstract

BACKGROUND

Diabetic Retinopathy (DR) is an important microvascular complication of diabetes that can lead to irreversible blindness. Microalbuminuria is strongly associated with diabetic retinopathy and can be used as a reliable marker of diabetic retinopathy.

AIM

To assess the association between DR, microalbuminuria, and other modifiable risk factors in patients with type 2 diabetes.

METHODOLOGY

3090 patients with T2DM visiting North Delhi Diabetes Centre, New Delhi between July 2016 to October 2019 were evaluated for the clinical and biochemical parameters that included urinary albumin, HbA1C, lipid profiles, serum creatinine estimation and underwent biothesiometry.

RESULTS

3090 patients (1350 females and 1740 males), with mean age of 52.7 ± 9.2 years and diabetes duration ranging from 1 to 19 years (mean 9.4 ± 6), duration of less than 5 years, 6-10 years and more than 10 years in 52%, 26% and in 22%, respectively. Duration of diabetes was strong predictor of retinopathy (p = 0.001). The HbA1c and BMI in patients with DR was significantly higher than in those without DR. 18.2% patients were diagnosed to have retinopathy. Peripheral neuropathy was observed in 24.2% and was positively associated with DR (p = 0.002). 33.9% and 4.5% patients had microalbuminuria macroalbuminuria, respectively and 9.7% patients had creatinine >1.3 mg/dL. There was significant positive relationship between different grades of retinopathy and albuminuria.

CONCLUSIONS

Our study is a large real-world study that demonstrates that HbA1c, BMI, duration of diabetes, microalbuminuria and peripheral neuropathy are relatively, yet cohesively contributing factors towards varying grade of retinopathy.

摘要

背景

糖尿病视网膜病变(DR)是糖尿病的一种重要的微血管并发症,可导致不可逆性失明。微量白蛋白尿与糖尿病视网膜病变密切相关,可作为糖尿病视网膜病变的可靠标志物。

目的

评估 2 型糖尿病患者中 DR、微量白蛋白尿和其他可改变的危险因素之间的关联。

方法

2016 年 7 月至 2019 年 10 月,对 3090 名在新德里北德里糖尿病中心就诊的 T2DM 患者进行了临床和生化参数评估,这些参数包括尿白蛋白、HbA1C、血脂谱、血清肌酐估计值,并进行了生物感觉测定。

结果

3090 名患者(1350 名女性和 1740 名男性),平均年龄为 52.7 ± 9.2 岁,糖尿病病程 1-19 年(平均 9.4 ± 6 年),病程<5 年、6-10 年和>10 年的患者分别占 52%、26%和 22%。糖尿病病程是视网膜病变的强预测因素(p = 0.001)。DR 患者的 HbA1c 和 BMI 显著高于无 DR 患者。18.2%的患者被诊断为视网膜病变。周围神经病变发生率为 24.2%,与 DR 呈正相关(p = 0.002)。33.9%和 4.5%的患者分别有微量白蛋白尿和大量白蛋白尿,9.7%的患者肌酐>1.3mg/dL。不同程度的视网膜病变与白蛋白尿之间存在显著的正相关关系。

结论

我们的研究是一项大型真实世界研究,表明 HbA1c、BMI、糖尿病病程、微量白蛋白尿和周围神经病变是导致不同程度视网膜病变的相对但协同的因素。

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