1464 例 1 型糖尿病成年患者糖尿病视网膜病变的患病率、严重程度分期和危险因素。
Prevalence, severity stages, and risk factors of diabetic retinopathy in 1464 adult patients with type 1 diabetes.
机构信息
University of Paris, Ophthalmology Department, AP-HP, Lariboisière Hospital, F-75010, Paris, France.
Department of Diabetology and Endocrinology, Lariboisière Hospital, AP-HP, 2 rue Ambroise Paré, Paris, France. Unité INSERM U1138 Immunity and Metabolism in Diabetes, ImMeDiab Team, Centre de Recherches des Cordeliers, Paris, France. Université de Paris, Paris, France.
出版信息
Graefes Arch Clin Exp Ophthalmol. 2021 Dec;259(12):3613-3623. doi: 10.1007/s00417-021-05298-7. Epub 2021 Jul 15.
PURPOSE
To determine the prevalence of diabetic retinopathy (DR) and its risk factors in adult type 1 diabetes (T1D) patients METHODS: In this cross-sectional study, all T1D patients followed in the University Center for Diabetes and its Complications of Lariboisière Hospital (Paris, France) between January 2017 and February 2019 were included. Ophthalmologic and systemic data were collected from electronic records. The association between DR (and each grade) and associated factors were estimated by univariate and multivariate analyses using logistic regression models.
RESULTS
A total of 1464 patients (46.2% of women, mean age: 42.2 ± 15.8 years) were included. The mean hemoglobin A1c (HbA1c) was 7.8 ± 1.7% and the mean diabetes duration was 20.5 ± 13.5 years. DR prevalence was 50.1% (47.4-52.6) and the prevalence of mild, moderate, and severe non-proliferative DR and proliferative DR was 19.1%, 9.4%, 3.9%, and 17.6%, respectively. DR was significantly associated with male gender, an older age, former and current smoking status, a higher BMI, the presence of nephropathy and neuropathy, higher HBA1c, and longer diabetes duration. Patients with HbA1c > 10% had an adjusted odds ratio (OR) of 3.25 (1.77-6.01) of having DR compared to patients with HbA1c < 6.5%. Patients with a diabetes duration > 30 years had an adjusted OR of 24.87 (14.82-42.67) higher of having DR compared to patients with a diabetes duration < 10 years.
CONCLUSION
In this study, 50.1% of adult T1D patients had DR and 17.6% had proliferative DR. Diabetes duration and HbA1c were major risk factors.
目的
确定成年 1 型糖尿病（T1D）患者中糖尿病视网膜病变（DR）的患病率及其危险因素。
方法
本横断面研究纳入了 2017 年 1 月至 2019 年 2 月期间在巴黎拉罗什-比里尼厄大学糖尿病及其并发症中心（法国）接受治疗的所有 T1D 患者。从电子病历中收集眼科和系统数据。采用 logistic 回归模型的单变量和多变量分析来评估 DR（及其各等级）与相关因素之间的关联。
结果
共纳入 1464 例患者（46.2%为女性，平均年龄：42.2±15.8 岁）。平均糖化血红蛋白（HbA1c）为 7.8±1.7%，平均糖尿病病程为 20.5±13.5 年。DR 患病率为 50.1%（47.4-52.6），轻度、中度和重度非增殖性 DR 以及增殖性 DR 的患病率分别为 19.1%、9.4%、3.9%和 17.6%。DR 与男性性别、年龄较大、既往和现在吸烟状态、更高的 BMI、肾病和神经病变的存在、更高的 HBA1c 和更长的糖尿病病程显著相关。HbA1c>10%的患者与 HbA1c<6.5%的患者相比，患有 DR 的调整后优势比（OR）为 3.25（1.77-6.01）。糖尿病病程>30 年的患者与糖尿病病程<10 年的患者相比，患有 DR 的调整后 OR 为 24.87（14.82-42.67）。
结论
在这项研究中，50.1%的成年 T1D 患者患有 DR，17.6%患有增殖性 DR。糖尿病病程和 HbA1c 是主要的危险因素。
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