Seyyar Sevim Ayça, Tıskaoğlu Nesime Setge, Onder Tokuc Ecem, Mercanlı Murat, Doğan Levent
Kocaeli Derince Education and Research Hospital Ophthalmology Department, Kocaeli, Turkey.
Ersin Arslan Education and Research Hospital Ophthalmology Department, Gaziantep, Turkey.
Clin Exp Optom. 2023 Aug;106(6):612-618. doi: 10.1080/08164622.2022.2090232. Epub 2022 Jul 3.
Vitamin D (VitD) deficiency, which is found in approximately one-third of the population of the world, may play a role in the pathogenesis of diabetic retinopathy. Physicians following diabetes patients should be aware of this relationship and should refer patients to for ophthalmic care for control in a timely manner.
Diabetic retinopathy is one of the most common complications of diabetic microvascular disease. VitD deficiency has been implicated in the pathogenesis and progression of diabetes and may have a role in development and severity of diabetic retinopathy. The aim of this study was to examine the relationship of serum VitD and some laboratory parameters with the presence of diabetes and retinopathy.
In this study, which has a retrospective epidemiological study design, comprehensive ophthalmologic examination data from the eye clinic, laboratory data from fasting blood tests, and internal medicine outpatient clinic examination data were reviewed. All participants were divided into four groups: 109 healthy controls, and 165 patients with type 2 diabetes of whom 54 did not have retinopathy, 64 had proliferative diabetic retinopathy, and 47 had non-proliferative diabetic retinopathy. Participants were also divided into four groups according to their serum VitD levels. Serum 25(OH)D, HbA, creatine, calcium, phosphate, triglyceride, low-density lipoprotein, and high-density lipoprotein levels were evaluated.
In the whole study cohort, 152 (55.5%) were female and 122 (44.5%) were male. A statistically significant difference was observed in VitD between the healthy group and the diabetic and proliferative diabetic retinopathy groups (p ≤ 0.001). However, no significant correlation was observed between the presence of diabetes and retinopathy and serum VitD in logistic regression analyses (p > 0.05).
Diabetic patients have lower 25(OH)D than non-diabetic patients and there is no direct relationship between 25(OH)D and the development of diabetic retinopathy.
维生素D（VitD）缺乏在全球约三分之一的人口中存在，可能在糖尿病视网膜病变的发病机制中起作用。诊治糖尿病患者的医生应了解这种关系，并应及时将患者转诊至眼科进行检查。
糖尿病视网膜病变是糖尿病微血管疾病最常见的并发症之一。VitD缺乏与糖尿病的发病机制和进展有关，可能在糖尿病视网膜病变的发生和严重程度中起作用。本研究的目的是探讨血清VitD和一些实验室参数与糖尿病及视网膜病变之间的关系。
本研究采用回顾性流行病学研究设计，回顾了眼科门诊的综合眼科检查数据、空腹血液检查的实验室数据以及内科门诊检查数据。所有参与者分为四组：109名健康对照者，165名2型糖尿病患者，其中54名无视网膜病变，64名有增殖性糖尿病视网膜病变，47名有非增殖性糖尿病视网膜病变。参与者还根据血清VitD水平分为四组。评估血清25（OH）D、糖化血红蛋白（HbA）、肌酐、钙、磷、甘油三酯、低密度脂蛋白和高密度脂蛋白水平。
在整个研究队列中，152名（55.5%）为女性，122名（44.5%）为男性。健康组与糖尿病组及增殖性糖尿病视网膜病变组之间的VitD水平存在统计学显著差异（p≤0.001）。然而，在逻辑回归分析中，糖尿病及视网膜病变的存在与血清VitD之间未观察到显著相关性（p>0.05）。
糖尿病患者的25（OH）D水平低于非糖尿病患者，且25（OH）D与糖尿病视网膜病变的发生无直接关系。
