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泰国最大的国立三级转诊中心诗里拉吉医院糖尿病患者糖尿病视网膜病变的患病率及相关因素

Prevalence of and Factors Associated with Diabetic Retinopathy in Patients with Diabetes Mellitus at Siriraj Hospital - Thailand's Largest National Tertiary Referral Center.

作者信息

Boonsaen Thirajit, Choksakunwong Sawaraj, Lertwattanarak Raweewan

机构信息

Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

出版信息

Diabetes Metab Syndr Obes. 2021 Dec 29;14:4945-4957. doi: 10.2147/DMSO.S346719. eCollection 2021.

Abstract

PURPOSE

We aimed to determine the prevalence of and factors associated with diabetic retinopathy (DR) in patients with diabetes mellitus (DM) and to evaluate the relationship between significant factors and severity of DR.

PATIENTS AND METHODS

A retrospective cross-sectional study of 1130 diabetic patients (mean age: 60 years, 62.7% female, 91% type 2 diabetes) was conducted in the diabetes clinic of Siriraj Hospital (Bangkok, Thailand) during January 2012 to June 2015. DR was graded as absent, mild, moderate, or severe non-proliferative DR, or proliferative DR. Multivariate logistic regression analysis was used to identify independent risk factors for DR in DM patients.

RESULTS

The overall prevalence of DR was 34.78%. Multivariate analysis revealed duration of diabetes, glycated hemoglobin level (HbA), presence of albuminuria, and abnormal protective sensation to be independent risk factors for DR. The prevalence of DR increased with longer duration of diabetes ( < 0.001), deterioration of glucose control ( = 0.006 for HbA), presence of significant albuminuria ( = 0.010), and loss of protective sensation ( = 0.001).

CONCLUSION

In this study, one-third of DM were found to have DR. The independent predictors of DR were duration of diabetes, HbA level, presence of significant albuminuria, and impaired protective sensation. Heightened awareness of these risk factors will decrease the prevalence and severity of DR, and will improve early diagnosis and treatment of DR.

摘要

目的

我们旨在确定糖尿病(DM)患者中糖尿病视网膜病变(DR)的患病率及其相关因素,并评估重要因素与DR严重程度之间的关系。

患者与方法

2012年1月至2015年6月期间,在泰国曼谷诗里拉吉医院的糖尿病门诊对1130例糖尿病患者(平均年龄:60岁,女性占62.7%,91%为2型糖尿病)进行了一项回顾性横断面研究。DR被分为无、轻度、中度或重度非增殖性DR,或增殖性DR。采用多因素逻辑回归分析确定DM患者DR的独立危险因素。

结果

DR的总体患病率为34.78%。多因素分析显示糖尿病病程、糖化血红蛋白水平(HbA)、蛋白尿的存在以及保护性感觉异常是DR的独立危险因素。DR的患病率随着糖尿病病程延长(<0.001)、血糖控制恶化(HbA为0.006)、显著蛋白尿的存在(=0.010)以及保护性感觉丧失(=0.001)而增加。

结论

在本研究中,发现三分之一的DM患者患有DR。DR的独立预测因素为糖尿病病程、HbA水平、显著蛋白尿的存在以及保护性感觉受损。提高对这些危险因素的认识将降低DR的患病率和严重程度,并改善DR的早期诊断和治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8166/8721031/6bfe59ca9636/DMSO-14-4945-g0001.jpg

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