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伴有和不伴有视网膜病变的微量白蛋白尿糖尿病患者的视网膜微循环改变

Retinal Microcirculation Alterations in Microalbuminuric Diabetic Patients With and Without Retinopathy.

作者信息

Ucgul Atilgan Cemile, Atilgan Kadir Gokhan, Kosekahya Pinar, Goker Yasin Sakir, Karatepe Mustafa Salih, Caglayan Mehtap, Citirik Mehmet

机构信息

Department of Ophthalmology, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey.

Department of Nephrology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.

出版信息

Semin Ophthalmol. 2021 Aug 18;36(5-6):406-412. doi: 10.1080/08820538.2021.1896745. Epub 2021 Mar 10.

Abstract

PURPOSE

To investigate the effect of microalbuminuria (MA) on superficial vessel density (SVD), deep vessel density (DVD), and choriocapillaris vessel density (CVD) in type-2 diabetic patients.

METHODS

Twenty patients without diabetic retinopathy (DR) and MA (group 1), 20 patients without DR but with MA (group 2) and 30 patients with mild DR and MA (group 3) were enrolled in this prospective and cross-sectional study. SVD, DVD, and CVD of all patients were screened with optical coherence tomography angiography (OCTA). The relationships between these values and age, diabetes duration and metabolic parameters were also evaluated.

RESULTS

The whole macular SVD value was 50.15 ± 4.52 in group 1 and 47.81 ± 4.12 in group 2 ( = .04). The whole macular DVD value was 47.66 ± 2.76 in group 1, 44.37 ± 3.39 in group 3 ( = .02). Parafoveal DVD value was 52.58 ± 3.47 in group 1, 51.84 ± 2.23 in group 2, and 49.23 ± 3.38 in group 3 (p G1&3 = .001, p G2&3 = .02). Perifoveal DVD value was 47.92 ± 3.30 in group 1, 43.96 ± 4.19 in group 2, and 42.85 ± 2.98 in group 3 (p G1&2 = .02 and p G1&3 < .001). There were inverse correlations between diabetes duration, urea, creatinine, albumin, urinary sodium and some DVD values ( < .05, for all). Also, there were inverse correlations between parafoveal and perifoveal DVD values and MA ( = .002 and = .031). Additionally, inverse correlations were determined between diabetes duration, creatinine, urea, serum Na and some CVD values ( < .05 for all).: Decreased SVD and DVD values measured by OCTA in type-2 diabetic patients, whether they have mild DR or not, may be associated with MA causing early retinal microvascular changes.

摘要

目的

探讨微量白蛋白尿(MA)对2型糖尿病患者浅表血管密度(SVD)、深部血管密度(DVD)和脉络膜毛细血管血管密度(CVD)的影响。

方法

本前瞻性横断面研究纳入了20例无糖尿病视网膜病变(DR)和MA的患者(第1组)、20例无DR但有MA的患者(第2组)和30例有轻度DR和MA的患者(第3组)。所有患者的SVD、DVD和CVD均采用光学相干断层扫描血管造影(OCTA)进行筛查。还评估了这些值与年龄、糖尿病病程和代谢参数之间的关系。

结果

第1组全黄斑SVD值为50.15±4.52,第2组为47.81±4.12(P = 0.04)。第1组全黄斑DVD值为47.66±2.76,第3组为44.37±3.39(P = 0.02)。第1组黄斑旁DVD值为52.58±3.47,第2组为51.84±2.23,第3组为49.23±3.38(第1组与第3组比较P = 0.001,第2组与第3组比较P = 0.02)。第1组黄斑周围DVD值为47.92±3.30,第2组为43.96±4.19,第3组为42.85±2.98(第1组与第2组比较P = 0.02,第1组与第3组比较P < 0.001)。糖尿病病程、尿素、肌酐、白蛋白、尿钠与一些DVD值之间存在负相关(均P < 0.05)。此外,黄斑旁和黄斑周围DVD值与MA之间存在负相关(P = 0.002和P = 0.031)。此外,糖尿病病程、肌酐、尿素、血清钠与一些CVD值之间也存在负相关(均P < 0.05)。结论:2型糖尿病患者,无论是否有轻度DR,通过OCTA测量的SVD和DVD值降低可能与MA导致早期视网膜微血管改变有关。

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