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新发 2 型糖尿病患者的糖尿病视网膜病变早期筛查及其对发病率和临床治疗的影响:一项全国性基于人群的队列研究。

Early Screening for Diabetic Retinopathy in Newly Diagnosed Type 2 Diabetes and Its Effectiveness in Terms of Morbidity and Clinical Treatment: A Nationwide Population-Based Cohort.

机构信息

Department of Ophthalmology, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan.

Graduate Institute of Business Administration, Fu Jen Catholic University, New Taipei City, Taiwan.

出版信息

Front Public Health. 2022 Apr 26;10:771862. doi: 10.3389/fpubh.2022.771862. eCollection 2022.

Abstract

PURPOSE

To characterize the association between the frequency of screening for diabetic retinopathy (DR) and the detection of DR in patients with newly diagnosed type 2 diabetes mellitus (T2DM).

METHODS

This nationwide population-based cohort study used data from the National Health Insurance Research Database to identify adult patients who were newly diagnosed with T2DM between 2000 and 2004. Data from their follow-up Diabetic retinopathy (DR) treatments over the next 10 years following diagnosis were also analyzed.

RESULTS

The 41,522 subjects were respectively assigned to a periodic screening group ( = 3850) and nonperiodic screening group ( = 37,672). Significant differences were observed between the two groups in terms of age, Charlson Comorbidity Index (CCI), sex, DR treatment, and the prevalence of DR. The association between periodic screening and DR treatment, only the elderly, female, and patient with severe CCI status showed the significance in the further stratified analysis.

CONCLUSION

Periodic screening (annual or biannual screening in the first 5 years) was more effective than nonperiodic screening in detecting instances of DR in the middle-to-advanced aged group but not among younger patients. Screening pattern did not have a significant effect on the likelihood of DR-related treatment during the 5-year follow-up. It appears that a tight screening schedule for the first 5 years after diagnosis with diabetes is not necessary.

摘要

目的

描述糖尿病视网膜病变(DR)筛查频率与新诊断 2 型糖尿病(T2DM)患者 DR 检出率之间的相关性。

方法

本项全国性基于人群的队列研究使用国家健康保险研究数据库的数据,确定了 2000 年至 2004 年间新诊断为 T2DM 的成年患者。还分析了他们在诊断后接下来的 10 年内接受 DR 治疗的数据。

结果

41522 名患者分别被分配到定期筛查组(n=3850)和非定期筛查组(n=37672)。两组在年龄、Charlson 合并症指数(CCI)、性别、DR 治疗和 DR 患病率方面存在显著差异。在进一步分层分析中,仅在年龄较大、女性和 CCI 严重的患者中,定期筛查与 DR 治疗之间存在关联。

结论

与非定期筛查相比,定期筛查(前 5 年每年或每两年筛查一次)在中老年人群中更有效地检测到 DR,但在年轻患者中则不然。在 5 年随访期间,筛查模式对 DR 相关治疗的可能性没有显著影响。这表明在诊断后前 5 年内不需要对糖尿病进行严格的筛查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fca/9094682/e707ba8c09d8/fpubh-10-771862-g0001.jpg

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