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遗传易感性对发生威胁视力的糖尿病视网膜病变的风险有影响。

The Risk for Developing Vision Threatening Diabetic Retinopathy is Influenced by Heredity to Diabetes.

机构信息

Department of Ophthalmology, Aarhus University Hospital, Aarhus N, Denmark.

出版信息

Curr Eye Res. 2022 Sep;47(9):1322-1328. doi: 10.1080/02713683.2022.2067564. Epub 2022 Jul 19.

Abstract

Clustering of vision threatening diabetic retinopathy within specific families can be the result of similarities in life style but may also be due to a common genetic background. An evaluation of the role of heredity for the development of diabetic retinopathy may help adjusting control intervals in screening program to each patient's individual risk profile. Survival analysis was used to study whether family history of diabetes among men and women with type 1 or type 2 diabetes together with the degree of heredity could be added as risk factors to improve the prediction of the risk for developing proliferative diabetic retinopathy (PDR) and diabetic macular edema (DME). The study was conducted on data from 12,281 patients followed in the Aarhus area, Denmark, from 1 January 2003 to 1 July 2019. The risk for developing PDR was significantly reduced 2-11 years after known onset of diabetes in the presence of female family members with type 1 diabetes, and the risk for developing DME significantly increased 4-24 years after onset of diabetes in the presence of family members with type 2 diabetes of any sex. These hereditary factors were independent of other studied risk factors such as previous cataract surgery, age of onset of diabetes, metabolic regulation and blood pressure. The presence of family members with diabetes affects the risk for developing vision threatening diabetic retinopathy and affects the risk for developing PDR and DME differently. This evidence may help individualizing the control intervals in screening programmes for diabetic retinopathy.

摘要

威胁视力的糖尿病视网膜病变在特定家族中聚集可能是生活方式相似的结果,但也可能是由于共同的遗传背景。评估遗传因素在糖尿病视网膜病变发展中的作用可能有助于根据每个患者的个体风险状况调整筛查计划的控制间隔。生存分析用于研究 1 型或 2 型糖尿病男性和女性的糖尿病家族史以及遗传程度是否可以作为危险因素添加到预测发生增殖性糖尿病视网膜病变(PDR)和糖尿病性黄斑水肿(DME)的风险中。该研究基于 2003 年 1 月 1 日至 2019 年 7 月 1 日在丹麦奥胡斯地区接受随访的 12,281 名患者的数据进行。在存在 1 型糖尿病女性家族成员的情况下,糖尿病发病后 2-11 年发生 PDR 的风险显著降低,而在存在任何性别的 2 型糖尿病家族成员的情况下,糖尿病发病后 4-24 年发生 DME 的风险显著增加。这些遗传因素独立于其他研究的危险因素,如先前的白内障手术、糖尿病发病年龄、代谢调节和血压。有糖尿病家族成员存在会影响发生威胁视力的糖尿病性视网膜病变的风险,并以不同的方式影响发生 PDR 和 DME 的风险。这一证据可能有助于为糖尿病视网膜病变的筛查计划个体化控制间隔。

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