Debele Gebiso Roba, Kanfe Shuma Gosha, Weldesenbet Adisu Birhanu, Ayana Galana Mamo, Jifar Wakuma Wakene, Raru Temam Beshir
Department of Public Health, College of Health Sciences, Mettu University, Mettu, Ethiopia.
Department of Health Informatics, College of Health Sciences, Mettu University, Mettu, Ethiopia.
Diabetes Metab Syndr Obes. 2021 Mar 22;14:1305-1313. doi: 10.2147/DMSO.S300373. eCollection 2021.
With an increasing number of diabetes patients in developing countries, the burden of diabetes-related blindness is undoubtedly posing a massive challenge to the sustainable health care system due to the cost of care. Despite this fact, to date, most of the epidemiological research on diabetic retinopathy (DR) in eastern Africa, including Ethiopia, has been limited to survey studies. Thus, we determined the incidence of retinopathy and its predictors among diabetic patients in Jimma University Medical Center, Southwest Ethiopia.
A retrospective follow-up study was conducted on 402 randomly selected diabetic patients of aged ≥15 years. A preliminary reviewed checklist was used to obtain information on the demographics, clinical and physiological attributes. Data were entered using EpiData version 4.6 and analyzed using Stata version 14. All variables at -values less than 0.2 in bivariable analysis were exported to multivariable analysis. Multivariable accelerated failure time (AFT) regression analyses using Weibull distribution were used to examine the predictors of DR at a 5% level of significance.
Throughout a median follow-up period of 5.9 years, the cumulative incidence of DR was 20.15% (95%CI: 16.50-24.37) and the incidence rate was 36.9 per 1000 person years (PY) (95%CI: 29.7-45.9). Multivariable Weibull AFT regression analyses showed that type two diabetes mellitus (T2DM) (adjusted time ratio (ATR) 0.4095%CI: 0.20-0.78), hypertension (HTN) (ATR 0.54; 95%CI: [0.35, 0.82]), low high density lipoprotein cholesterol (HDL-C) (ATR 0.51; 95%CI: 0.36-0.73), and borderline high total cholesterol (TC) (ATR 0.63; 95%CI: 0.42-0.94) were a predictor of time to DR.
The overall incidence of DR among patients with diabetes mellitus was estimated to be 20.15% and is becoming a public health burden in Ethiopia. Our results indicate that T2DM, HTN, low HDL-C and borderline high TC independently predicts an increased incidence/decreased survival time of retinopathy among diabetes patients. The low HDL-C, HTN, and high TC are modifiable risk factors that should be managed along with diabetes.
随着发展中国家糖尿病患者数量的增加，由于护理成本，糖尿病相关失明的负担无疑给可持续医疗系统带来了巨大挑战。尽管如此，迄今为止，包括埃塞俄比亚在内的东非地区关于糖尿病视网膜病变（DR）的大多数流行病学研究都局限于调查研究。因此，我们确定了埃塞俄比亚西南部吉马大学医学中心糖尿病患者中视网膜病变的发病率及其预测因素。
对402名年龄≥15岁的随机选择的糖尿病患者进行了回顾性随访研究。使用初步审查的清单获取有关人口统计学、临床和生理特征的信息。数据使用EpiData 4.6版本录入，并使用Stata 14版本进行分析。在双变量分析中P值小于0.2的所有变量都被纳入多变量分析。使用威布尔分布的多变量加速失效时间（AFT）回归分析在5%的显著性水平下检查DR的预测因素。
在中位随访期5.9年期间，DR的累积发病率为20.15%（95%CI：16.50 - 24.37），发病率为每1000人年36.9例（95%CI：29.7 - 45.9）。多变量威布尔AFT回归分析表明，2型糖尿病（T2DM）（调整时间比（ATR）0.40；95%CI：0.20 - 0.78）、高血压（HTN）（ATR 0.54；95%CI：[0.35, 0.82]）、低高密度脂蛋白胆固醇（HDL-C）（ATR 0.51；95%CI：0.36 - 0.73）和临界高总胆固醇（TC）（ATR 0.63；95%CI：0.42 - 0.94）是DR发生时间的预测因素。
糖尿病患者中DR的总体发病率估计为20.15%，在埃塞俄比亚正成为一个公共卫生负担。我们的结果表明，T2DM、HTN、低HDL-C和临界高TC独立预测糖尿病患者视网膜病变的发病率增加/生存时间缩短。低HDL-C、HTN和高TC是可改变的危险因素，应与糖尿病一起进行管理。
