Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Key Laboratory of Ophthalmology, Department of Ophthalmology, Hebei Eye Hospital, Xingtai, China.
Front Endocrinol (Lausanne). 2022 Aug 8;13:966619. doi: 10.3389/fendo.2022.966619. eCollection 2022.
The present study examined the prevalence and risk factors for diabetic retinopathy (DR) in residents with abnormal glucose metabolism in a community.
6029 subjects were included and underwent standardized interviews and comprehensive examinations. Residents with diabetes were divided into nondiabetic retinopathy (NDR) and DR groups and non-hypertension and hypertension groups. Unconditional multivariate logistic regression models were used to analyze the risk factors for DR in different groups.
The prevalence of DR in diabetes was 9.9%, and the prevalence of retinopathy, which also has the typical signs of DRs, such as retinal microaneurysms, in prediabetes and normal glucose tolerance was 5.2% and 5.3%, respectively. An elevated waist-to-hip ratio (WHR) (female≥0.85, male≥0.9)[OR 1.683, 95% CI (1.016, 2.790)], systolic blood pressure (SBP)≥140 mmHg [OR 1.875, 95% CI (1.158, 3.034)], elevated HbA1c [OR 1.410, 95% CI (1.220, 1.629)], HbA1c ≥6.5% [OR 2.149, 95% CI (1.320, 3.498)], antidiabetic drug use [OR 3.798, 95% CI (2.209, 6.529)], elevated fasting blood glucose [OR 1.176, 95% CI (1.072, 1.289)], elevated postprandial blood glucose [OR 1.090, 95% CI (1.033, 1.150)] and nonspecific ST-T segment changes on electrocardiography [OR 2.555, 95% CI (1.556, 4.196)] were risk factors for DR. Duration of diabetes [OR 1.206, 95% CI (1.028, 1.415)], elevated WHR [OR 3.796, 95% CI (1.144, 12.603)], elevated waist circumference [OR 6.874, 95% CI (1.403, 33.665)], elevated HbA1c [OR 1.435, 95% CI (1.046, 1.970)], HbA1c ≥6.5% [OR 6.850, 95% CI (1.771, 26.501)], and concurrent metabolic syndrome [OR 3.975, 95% CI (1.144, 13.815)] were risk factors for DR in diabetes without hypertension, and elevated HbA1c [OR 1.395, 95% CI (1.183, 1.645)], HbA1c ≥6.5% [OR 1.745, 95% CI (1.027, 2.966)], use of antidiabetic drugs [OR 4.781, 95% CI (2.624, 8.711)], elevated fasting blood glucose [OR 1.146, 95% CI (1.034, 1.270)], elevated postprandial blood glucose [OR 1.083, 95% CI (1.020, 1.151)], and nonspecific ST-T segment changes on electrocardiography [OR 2.616, 95% CI (1.531, 4.469)] were risk factors for DR in diabetes with hypertension.
Retinopathy was found in subjects with normal glucose tolerance and prediabetes. There were differences in risk factors for DR in diabetic patients with and without hypertension.
本研究旨在调查社区中葡萄糖代谢异常居民中糖尿病视网膜病变（DR）的患病率和危险因素。
纳入 6029 名受试者，进行标准化访谈和全面检查。将糖尿病患者分为非糖尿病性视网膜病变（NDR）和 DR 组以及非高血压和高血压组。采用非条件多变量逻辑回归模型分析不同组中 DR 的危险因素。
糖尿病患者中 DR 的患病率为 9.9%，而在糖尿病前期和糖耐量正常者中，具有典型 DR 特征的视网膜病变患病率分别为 5.2%和 5.3%。腰臀比（WHR）升高（女性≥0.85，男性≥0.9）（OR 1.683，95%CI（1.016，2.790））、收缩压（SBP）≥140mmHg（OR 1.875，95%CI（1.158，3.034））、糖化血红蛋白（HbA1c）升高（OR 1.410，95%CI（1.220，1.629））、HbA1c≥6.5%（OR 2.149，95%CI（1.320，3.498））、使用抗糖尿病药物（OR 3.798，95%CI（2.209，6.529））、空腹血糖升高（OR 1.176，95%CI（1.072，1.289））、餐后血糖升高（OR 1.090，95%CI（1.033，1.150））和心电图非特异性 ST-T 段改变（OR 2.555，95%CI（1.556，4.196））是 DR 的危险因素。糖尿病病程（OR 1.206，95%CI（1.028，1.415））、WHR 升高（OR 3.796，95%CI（1.144，12.603））、腰围升高（OR 6.874，95%CI（1.403，33.665））、HbA1c 升高（OR 1.435，95%CI（1.046，1.970））、HbA1c≥6.5%（OR 6.850，95%CI（1.771，26.501））和同时患有代谢综合征（OR 3.975，95%CI（1.144，13.815））是糖尿病无高血压患者 DR 的危险因素，而 HbA1c 升高（OR 1.395，95%CI（1.183，1.645））、HbA1c≥6.5%（OR 1.745，95%CI（1.027，2.966））、使用抗糖尿病药物（OR 4.781，95%CI（2.624，8.711））、空腹血糖升高（OR 1.146，95%CI（1.034，1.270））、餐后血糖升高（OR 1.083，95%CI（1.020，1.151））和心电图非特异性 ST-T 段改变（OR 2.616，95%CI（1.531，4.469））是糖尿病合并高血压患者 DR 的危险因素。
在糖耐量正常和糖尿病前期患者中发现了视网膜病变。高血压和非高血压糖尿病患者的 DR 危险因素存在差异。
