Haffner S M, Fong D, Stern M P, Pugh J A, Hazuda H P, Patterson J K, van Heuven W A, Klein R
Department of Medicine, University of Texas Health Science Center, San Antonio 78284.
Diabetes. 1988 Jul;37(7):878-84. doi: 10.2337/diab.37.7.878.
Mexican Americans (MAs) have a threefold greater prevalence of non-insulin-dependent diabetes mellitus (NIDDM) than non-Hispanic Whites (NHWs). Because MA diabetic subjects have greater hyperglycemia and an earlier age of onset than NHW diabetic subjects, we postulated that diabetic MAs might also have more severe diabetic retinopathy. Stereoscopic retinal photographs of the seven standard fields of each eye were taken in 257 MAs and 56 NHWs with NIDDM. The photographs were read by the University of Wisconsin Fundus Photographic Reading Center and graded with standardized criteria. The MAs had a nonsignificantly increased risk of retinopathy relative to the NHWs [odds ratio (OR) = 1.71; 95% confidence interval (Cl) = (0.93, 3.17)]. The risk of severe retinopathy (proliferative or preproliferative) relative to background or no retinopathy was significantly greater in MAs than in NHWs [OR = 2.37; 95% Cl = (1.04, 5.39)]. After control by logistic regression for duration of disease, severity of hyperglycemia, age, and systolic blood pressure, MAs still had an increased risk of severe retinopathy relative to NHWs [OR = 3.18; 95% Cl = (1.32, 7.66)]. Severe retinopathy was related to duration of disease, hyperglycemia, and insulin therapy in both ethnic groups. Previously diagnosed MA diabetic subjects also had an increased prevalence of any retinopathy [OR = 2.39; 95% Cl = (1.63, 3.50)] and severe retinopathy [OR = 3.21; 95% Cl = (2.24, 4.59)] relative to previously diagnosed White diabetic subjects (n = 896) from Wisconsin.(ABSTRACT TRUNCATED AT 250 WORDS)
墨西哥裔美国人(MAs)患非胰岛素依赖型糖尿病(NIDDM)的患病率是非西班牙裔白人(NHWs)的三倍。由于MA糖尿病患者比NHW糖尿病患者有更高的血糖水平和更早的发病年龄,我们推测MA糖尿病患者可能也有更严重的糖尿病视网膜病变。对257名患有NIDDM的MA患者和56名NHW患者的每只眼睛的七个标准视野进行了立体视网膜照相。这些照片由威斯康星大学眼底照相阅读中心进行判读,并根据标准化标准进行分级。与NHW患者相比,MA患者患视网膜病变的风险非显著性增加[比值比(OR)=1.71;95%置信区间(Cl)=(0.93,3.17)]。与背景性或无视网膜病变相比,MA患者发生严重视网膜病变(增殖性或增殖前期)的风险显著高于NHW患者[OR = 2.37;95% Cl =(1.04,5.39)]。在通过逻辑回归控制疾病持续时间、高血糖严重程度、年龄和收缩压后,与NHW患者相比,MA患者发生严重视网膜病变的风险仍然增加[OR = 3.18;95% Cl =(1.32,7.66)]。在两个种族群体中,严重视网膜病变均与疾病持续时间、高血糖和胰岛素治疗有关。与来自威斯康星州的先前诊断的白人糖尿病患者(n = 896)相比,先前诊断的MA糖尿病患者发生任何视网膜病变[OR = 2.39;95% Cl =(1.63,3.50)]和严重视网膜病变[OR = 3.21;95% Cl =(2.24,4.59)]的患病率也更高。(摘要截短于250字)