糖化血红蛋白（HbA1c）与其他生物标志物和糖尿病视网膜病变的患病率及严重程度之间的关联。
The Association Between HbA1c and Other Biomarkers With the Prevalence and Severity of Diabetic Retinopathy.
作者信息
Almutairi Noura M, Alahmadi Shoroog, Alharbi Mona, Gotah Sarah, Alharbi Majed
机构信息
College of Medicine, Taibah University, Medina, SAU.
出版信息
Cureus. 2021 Jan 6;13(1):e12520. doi: 10.7759/cureus.12520.
INTRODUCTION
Diabetes mellitus (DM) is considered to be a significant public health problem globally. According to the American Society of Retina Specialists, diabetic retinopathy (DR) is a complication of diabetes that causes damage to the blood vessels of the retina. In a Japanese study showed that HbA1c and fasting blood glucose values can be considered as predictors for the future development of DR. Thus, this study aimed to determine the prevalence and severity of DR among diabetic patients in Medina, Saudi Arabia, and to assess its relationship with HbA1c and other biomarkers.
METHODS
This cross-sectional study was conducted at Prince Abdulaziz Bin Majed Diabetes Center and Charitable Healthcare Society in Medina, Saudi Arabia, in July 2018. The data were collected from direct interview questionnaires that were administered to 130 randomly selected diabetic subjects. The subjects' demographic information, eye disease history, medical backgrounds, and laboratory biomarkers were noted. Fundus examinations using a slit lamp were conducted by ophthalmic physicians to diagnose and grade DR. The data were analyzed using Statistical Package for Social Sciences (SPSS) (IBM Corp., Armonk, NY, USA).
RESULTS
All 130 diabetic patients were examined for DR. DR was prevalent among 35 (26.9%) of the participants. According to the DR severity grading, 95 (73.1%) had no apparent DR, 11 (8.5%) had mild non-proliferative diabetic retinopathy (NPDR), 11 (8.5%) had moderate NPDR, 11 (8.5%) had severe NPDR, and only two (1.5%) had proliferative diabetic retinopathy (PDR). There was a significant association between the development of DR and HbA1c levels (p = 0.040). The duration of DM was also determined to be a significant risk factor for DR (p = 0.001). No other factors were found to have a significant association with DR.
CONCLUSION
Around one-third of the participants in our study had DR. HbA1c levels and duration of DM were established as important risk factors for DR. Screening is necessary, even in patients with good HbA1c levels, to avoid the late presentation of severe DR and to prevent blindness.
引言
糖尿病（DM）被认为是全球一个重大的公共卫生问题。根据美国视网膜专家协会的说法，糖尿病性视网膜病变（DR）是糖尿病的一种并发症，会导致视网膜血管受损。一项日本研究表明，糖化血红蛋白（HbA1c）和空腹血糖值可被视为DR未来发展的预测指标。因此，本研究旨在确定沙特阿拉伯麦地那糖尿病患者中DR的患病率和严重程度，并评估其与HbA1c及其他生物标志物的关系。
方法
这项横断面研究于2018年7月在沙特阿拉伯麦地那的阿卜杜勒阿齐兹·本·马吉德王子糖尿病中心和慈善医疗协会进行。数据收集自对130名随机选取的糖尿病患者进行的直接访谈问卷。记录了受试者的人口统计学信息、眼部疾病史、医学背景和实验室生物标志物。眼科医生使用裂隙灯进行眼底检查以诊断和分级DR。数据使用社会科学统计软件包（SPSS）（美国纽约州阿蒙克市IBM公司）进行分析。
结果
对所有130名糖尿病患者进行了DR检查。35名（26.9%）参与者患有DR。根据DR严重程度分级，95名（73.1%）没有明显的DR，11名（8.5%）患有轻度非增殖性糖尿病视网膜病变（NPDR），11名（8.5%）患有中度NPDR，11名（8.5%）患有重度NPDR，只有两名（1.5%）患有增殖性糖尿病视网膜病变（PDR）。DR的发生与HbA1c水平之间存在显著关联（p = 0.040）。DM病程也被确定为DR的一个显著危险因素（p = 0.001）。未发现其他因素与DR有显著关联。
结论
我们研究中约三分之一的参与者患有DR。HbA1c水平和DM病程被确定为DR的重要危险因素。即使是HbA1c水平良好的患者也有必要进行筛查，以避免严重DR的晚期出现并预防失明。
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