Department of Pediatric Endocrinology, Diabetes and Metabolic Diseases, University Children's Hospital, UMC Ljubljana, Ljubljana, Slovenia.
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
Pediatr Diabetes. 2022 Dec;23(8):1656-1664. doi: 10.1111/pedi.13416. Epub 2022 Sep 22.
To examine the prevalence, time trends, and risk factors of diabetic retinopathy (DR) among youth with type 1 diabetes (T1D) from 11 countries (Australia, Austria, Denmark, England, Germany, Italy, Luxemburg, Netherlands, Slovenia, United States, and Wales).
Data on individuals aged 10-21 years with T1D for >1 year during the period 2000-2020 were analyzed. We used a cross-sectional design using the most recent year of visit to investigate the time trend. For datasets with longitudinal data, we aggregated the variables per participant and observational year, using data of the most recent year to take the longest observation period into account. DR screening was performed through quality assured national screening programs. Multiple logistic regression models adjusted for the year of the eye examination, age, gender, minority status, and duration of T1D were used to evaluate clinical characteristics and the risk of DR.
Data from 156,090 individuals (47.1% female, median age 15.7 years, median duration of diabetes 5.2 years) were included. Overall, the unadjusted prevalence of any DR was 5.8%, varying from 0.0% (0/276) to 16.2% between countries. The probability of DR increased with longer disease duration (aOR = 1.04, 95% CI: 1.03-1.04, p < 0.0001), and decreased over time (aOR = 0.99, 95% CI: 0.98-1.00, p = 0.0093). Evaluating possible modifiable risk factors in the exploratory analysis, the probability of DR increased with higher HbA1c (aOR = 1.03, 95% CI: 1.03-1.03, p < 0.0001) and was higher among individuals with hypertension (aOR = 1.24, 95% CI: 1.11-1.38, p < 0.0001) and smokers (aOR = 1.30, 95% CI: 1.17-1.44, p < 0.0001).
The prevalence of DR in this large cohort of youth with T1D varied among countries, increased with diabetes duration, decreased over time, and was associated with higher HbA1c, hypertension, and smoking.
检查 11 个国家（澳大利亚、奥地利、丹麦、英格兰、德国、意大利、卢森堡、荷兰、斯洛文尼亚、美国和威尔士）的 1 型糖尿病（T1D）青年中糖尿病视网膜病变（DR）的患病率、时间趋势和危险因素。
分析了 2000-2020 年期间患有 T1D 且患病时间超过 1 年的 10-21 岁个体的数据。我们使用横断面设计，根据最近的就诊年份调查时间趋势。对于具有纵向数据的数据集，我们根据每个参与者和观察年份汇总变量，使用最新年份的数据考虑最长的观察期。DR 筛查通过质量保证的国家筛查计划进行。使用调整了眼部检查年份、年龄、性别、少数族裔身份和 T1D 持续时间的多因素逻辑回归模型来评估临床特征和 DR 风险。
共纳入 156090 名个体（47.1%为女性，中位年龄 15.7 岁，中位糖尿病病程 5.2 年）。总体而言，未经调整的任何 DR 患病率为 5.8%，各国之间差异从 0.0%（0/276）到 16.2%不等。DR 的发生概率随疾病持续时间的延长而增加（优势比 aOR=1.04，95%置信区间：1.03-1.04，p<0.0001），并且随时间呈下降趋势（aOR=0.99，95%置信区间：0.98-1.00，p=0.0093）。在探索性分析中评估可能的可改变危险因素时，DR 的发生概率随 HbA1c 升高而增加（aOR=1.03，95%置信区间：1.03-1.03，p<0.0001），并且在高血压（aOR=1.24，95%置信区间：1.11-1.38，p<0.0001）和吸烟者（aOR=1.30，95%置信区间：1.17-1.44，p<0.0001）中更高。
在该大型 T1D 青年队列中，DR 的患病率在各国之间存在差异，随糖尿病病程的延长而增加，随时间的推移而下降，并且与更高的 HbA1c、高血压和吸烟有关。
