Department of Ophthalmology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China.
Bengbu Medical College, Bengbu, Anhui, China.
PLoS One. 2022 Oct 4;17(10):e0275617. doi: 10.1371/journal.pone.0275617. eCollection 2022.
To investigate the prevalence and risk factors of diabetic retinopathy (DR) in a Chinese population with type 2 diabetes mellitus (T2DM) in a suburb (Qingpu) of Shanghai, China.
A population-based cross-sectional study. A total of 7462 residents with T2DM in Qingpu were enrolled according to the resident health archives from January 2020 to December 2020. Blood and urine samples of the subjects were collected. Disc- and macula-centred retinal images were taken to assess DR. SPSS was used to analyse and investigate the prevalence and risk factors of DR.
The fundus images of 6380 (85.5%) subjects were of sufficiently good quality for grading. The average (range) age of 6380 subjects was 63.46±7.77 (28-92) years. Six hundred forty-four subjects were diagnosed with DR. The prevalence of DR was 10.1% (95% CI 9.4%-10.8%), with mild, moderate, and severe non-proliferative retinopathy and proliferative retinopathy being 2.1%, 6.3%, 1.3% and 0.4%, respectively. The prevalence of bilateral DR was 6.5%. Higher T2DM duration (OR, 1.057), fasting plasma glucose (OR, 1.063), glycated hemoglobinA1c (OR, 1.269), urea nitrogen (OR, 1.059), and urinary albumin (OR, 1.001) were associated with the higher DR prevalence.
The prevalence of DR among Chinese adults with T2DM in Qingpu was 10.1%, in which non-proliferative DR was more common. Higher fasting plasma glucose and glycated hemoglobinA1c are well-known risk factors of DR, consistent with the findings in our study. Our study didn't find the risk between lipid indicators and DR. However, several renal function indicators, like higher urea nitrogen and urinary albumin, were risk factors for DR in this study. Appropriate diagnosis and intervention should be taken in time to prevent and control DR development.
本研究旨在调查中国上海青浦区 2 型糖尿病（T2DM）患者中糖尿病视网膜病变（DR）的患病率及其相关危险因素。
本研究采用基于人群的横断面研究设计。2020 年 1 月至 12 月，根据居民健康档案，共纳入青浦区 7462 例 T2DM 患者。采集患者的血液和尿液样本。对患者进行盘状和黄斑中心视网膜图像拍摄，以评估 DR。采用 SPSS 进行数据分析，探讨 DR 的患病率及其相关危险因素。
6380 例（85.5%）患者的眼底图像质量足够好，可用于分级。6380 例患者的平均（范围）年龄为 63.46±7.77（28-92）岁。644 例患者被诊断为 DR，DR 的患病率为 10.1%（95%可信区间 9.4%-10.8%），其中轻度、中度和重度非增生性视网膜病变及增生性视网膜病变的患病率分别为 2.1%、6.3%、1.3%和 0.4%。双侧 DR 的患病率为 6.5%。更长的 T2DM 病程（比值比，1.057）、空腹血糖（比值比，1.063）、糖化血红蛋白 A1c（比值比，1.269）、尿素氮（比值比，1.059）和尿白蛋白（比值比，1.001）与更高的 DR 患病率相关。
青浦区 T2DM 成人 DR 的患病率为 10.1%，其中非增生性 DR 更为常见。空腹血糖和糖化血红蛋白 A1c 升高是 DR 的已知危险因素，与本研究结果一致。本研究未发现血脂指标与 DR 之间存在相关性。然而，几项肾功能指标，如较高的尿素氮和尿白蛋白，是本研究中 DR 的危险因素。应及时采取适当的诊断和干预措施，以预防和控制 DR 的发展。
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