From the Family and Community Medicine Department (Alghamdi, Tourkmani, Alharbi, Alrasheed), Chronic Illness Center, Prince Sultan Military Medical City; and Biostatistician (Almadani), National Center of Evidence Based Health Practice, Saudi Health Council, Riyadh, Kingdom of Saudi Arabia.
Saudi Med J. 2021 Jun;42(6):693-697. doi: 10.15537/smj.2021.42.6.20210016.
To assess the prevalence and risk factors of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM) of different risks, based on the level of glycated hemoglobin (HbA1c).
A cross-sectional study was conducted in in the chronic illness clinics in Saudi Arabia between January 2019 and February 2020. Data were extracted from 428 T2DM patients' medical records and random sampling were carried out using a ratio of 1:3, matched for gender and duration of DM. Patients with HbA1c level ≥9% were classified as 'high-risk' and HbA1c ≤7% as 'low-risk'. Retinopathy was confirmed by an ophthalmologist using fundus photography.
The prevalence of DR in high-risk patient was 88.1% and 22.1% in low-risk patients. The prevalence of macular oedema was higher in the high-risk compared to low-risk patients (15.8% versus 4.9%, <0.001). Patients' mean age was 61±11 years and duration of diabetes was 13±7 years. Hemoglobin A1c and low-density lipoprotein (LDL) levels were significantly higher in high-risk patients (<0.0001) in bivariate but not multivariate analysis.
High HbA1c and LDL levels were associated with DR risk. Further multicentre studies involving large samples are required to assess the risk factors associated with DR progression.
根据糖化血红蛋白（HbA1c）水平，评估不同风险 2 型糖尿病（T2DM）患者中糖尿病视网膜病变（DR）的患病率和危险因素。
本横断面研究于 2019 年 1 月至 2020 年 2 月在沙特阿拉伯的慢性病诊所进行。从 428 例 T2DM 患者的病历中提取数据，并采用 1:3 的比例进行随机抽样，性别和 DM 持续时间相匹配。HbA1c 水平≥9%的患者被归类为“高风险”，HbA1c≤7%的患者被归类为“低风险”。通过眼底照相由眼科医生确认视网膜病变。
高风险患者中 DR 的患病率为 88.1%，低风险患者中为 22.1%。与低风险患者相比，高风险患者的黄斑水肿患病率更高（15.8%对 4.9%，<0.001）。患者的平均年龄为 61±11 岁，糖尿病病程为 13±7 年。高风险患者的 HbA1c 和低密度脂蛋白（LDL）水平在双变量分析中显著升高，但在多变量分析中无显著差异（<0.0001）。
高 HbA1c 和 LDL 水平与 DR 风险相关。需要进一步开展涉及大样本的多中心研究，以评估与 DR 进展相关的危险因素。
