糖尿病视网膜病变与年龄相关性黄斑变性患病率的关系。-开滦眼病研究。
The Association Between Diabetic Retinopathy and the Prevalence of Age-Related Macular Degeneration-The Kailuan Eye Study.
机构信息
Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology and Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
出版信息
Front Public Health. 2022 Jul 18;10:922289. doi: 10.3389/fpubh.2022.922289. eCollection 2022.
This study aimed to investigate the prevalence of age-related macular degeneration (AMD) in patients with diabetes mellitus (DM) and diabetic retinopathy (DR) and analyze whether DR is a risk factor for AMD. This population-based epidemiological study included 14,440 people from the Kailuan Eye Study in 2016, of whom 1,618 were patients with type 2 DM aged over 50 years, and 409 had DM with DR. We analyzed whether there were differences in the prevalence of AMD between DM with DR and DM without DR, and conducted a hierarchical statistical analysis according to different stages of DR. Using variable regression analysis, we explored whether DR constituted a risk factor for AMD. In the DM population, the prevalence of wet AMD in patients with DM with and without DR was 0. 3 and 0.2%, respectively, with no significant difference ( = 0.607). Meanwhile, the prevalence of dry AMD in patients with DM with and without DR was 20.8 and 16.0%, respectively, with a significant difference. In the subgroup analysis of dry AMD, the prevalence of early, middle, and late dry AMD in DM with DR was 14.4, 5.9, and 0.5%, respectively. In DM without DR, the prevalence of early, middle, and late dry AMD was 10.5, 4.8, and 0.7%, respectively ( = 0.031). In the subgroup analysis of DR staging, statistical analysis could not be performed because of the limited number of patients with PDR. In the variable regression analysis of risk factors for dry AMD, after adjusting for age, sex, body mass index, hypertension, and dyslipidemia, DR constituted the risk factor for dry AMD. In conclusion, DM did not constitute a risk factor for AMD, and the prevalence of wet AMD and dry AMD in patients with DM and DR was higher than that in patients with DM without DR (among which dry AMD was statistically significant). Multivariate regression analysis confirmed that DR is an independent risk factor for dry AMD. Reasonable control of DM and slowing down the occurrence and development of DR may effectively reduce the prevalence of AMD in patients with DM.
本研究旨在探讨年龄相关性黄斑变性（AMD）在糖尿病患者中的患病率，以及糖尿病视网膜病变（DR）是否为 AMD 的危险因素。本项基于人群的流行病学研究纳入了 2016 年开滦眼病研究中的 14440 人，其中 1618 人为年龄＞50 岁的 2 型糖尿病患者，409 人为合并 DR 的糖尿病患者。我们分析了合并 DR 的糖尿病患者与无 DR 的糖尿病患者的 AMD 患病率是否存在差异，并根据 DR 的不同分期进行分层统计分析。采用变量回归分析探讨 DR 是否为 AMD 的危险因素。在糖尿病患者中，合并或不合并 DR 的糖尿病患者中湿性 AMD 的患病率分别为 0.3%和 0.2%，差异无统计学意义（=0.607）。同时，合并或不合并 DR 的糖尿病患者中干性 AMD 的患病率分别为 20.8%和 16.0%，差异有统计学意义。在干性 AMD 的亚组分析中，合并 DR 的糖尿病患者中早期、中期和晚期干性 AMD 的患病率分别为 14.4%、5.9%和 0.5%，而无 DR 的糖尿病患者中早期、中期和晚期干性 AMD 的患病率分别为 10.5%、4.8%和 0.7%（=0.031）。在 DR 分期的亚组分析中，由于 PDR 患者数量有限，无法进行统计学分析。在干性 AMD 的危险因素的变量回归分析中，校正年龄、性别、体重指数、高血压和血脂异常后，DR 为干性 AMD 的危险因素。综上所述，糖尿病不是 AMD 的危险因素，合并 DR 的糖尿病患者中湿性 AMD 和干性 AMD 的患病率高于无 DR 的糖尿病患者（其中干性 AMD 有统计学意义）。多变量回归分析证实，DR 是干性 AMD 的独立危险因素。合理控制糖尿病，延缓 DR 的发生和发展，可能会有效降低糖尿病患者 AMD 的患病率。
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