埃塞俄比亚东南部成年糖尿病患者糖尿病视网膜病变的患病率及相关因素：一项基于医院的横断面研究
Prevalence and Factors Associated with Diabetic Retinopathy among Adult Diabetes Patients in Southeast Ethiopia: A Hospital-Based Cross-Sectional Study.
作者信息
Sahiledengle Biniyam, Assefa Tesfaye, Negash Wogene, Tahir Anwar, Regasa Tadele, Tekalegn Yohannes, Mamo Ayele, Teferu Zinash, Solomon Damtew, Gezahegn Habtamu, Bekele Kebebe, Zenbaba Demisu, Tasew Alelign, Desta Fikreab, Regassa Zegeye, Feleke Zegeye, Kene Chala, Tolcha Fekata, Gomora Degefa, Dibaba Diriba, Atlaw Daniel
机构信息
Public Health Department, Madda Walabu University, Goba Referral Hospital, Bale Goba, Ethiopia.
Nursing Department, Madda Walabu University, Goba Referral Hospital, Bale Goba, Ethiopia.
出版信息
Clin Ophthalmol. 2022 Oct 20;16:3527-3545. doi: 10.2147/OPTH.S385806. eCollection 2022.
BACKGROUND
Diabetic retinopathy (DR) is the most prevalent microvascular consequence of diabetes mellitus, and it can result in blindness that is irreversible. Due to delayed diagnosis and limited access to diabetic care, the situation is even worse in developing countries. Scientific evidence on the prevalence of DR and its associated factors among diabetes patients in low-income countries, such as Ethiopia, is limited. This study aimed to determine the prevalence of DR and associated factors among adult diabetes patients in southeast Ethiopia.
METHODS
A hospital-based cross-sectional study was conducted among diabetes patients who visited Madda Walabu University Goba Referral Hospital. Fundus and slit-lamp examination were performed for screening of DR. Multivariate binary logistic regression was computed to identify factors associated with DR.
RESULTS
A total of 256 patients (144 men, 56.2%) aged 50.15±15.71 years were included in the study. The prevalence of any DR was 19.9% (95% CI 15.4%-25.3%), mild nonproliferative diabetic retinopathy (NPDR) 10.9% (95% CI 7.6%-15.4%), moderate NPDR 5.9% (95% CI 3.5%-9.5%), severe NPDR 0.9% (95% CI 0.2%-3.9%), and proliferative DR 2.3% (95% CI 1.0%-5.1%). Duration of diabetes ≥10 years (AOR 10.22, 95% CI 1.70-61.44), central obesity (AOR 5.42, 95% CI 1.38-21.19), overweight/obese (AOR 2.65, 95% CI 1.02-6.92), lower high-density lipoprotein (HDL) cholesterol (AOR 5.82, 95% CI 1.86-18.24), moderate triglyceride:HDL cholesterol ratio (AOR 4.13, 95% CI 1.13-15.15), and urban dwelling (AOR 2.84, 95% CI 1.04-7.78) were significantly associated with DR.
CONCLUSION
One in every five DM patients had DR. Sociodemographic, anthropometric, and blood lipids were independently associated with DR. To reduce the burden of diabetes, strategies that focus on lifestyle modifications targeted at identified modifiable risk factors are essential.
背景
糖尿病视网膜病变（DR）是糖尿病最常见的微血管并发症，可导致不可逆的失明。由于诊断延迟和糖尿病护理服务有限，发展中国家的情况更为严峻。关于低收入国家（如埃塞俄比亚）糖尿病患者中DR患病率及其相关因素的科学证据有限。本研究旨在确定埃塞俄比亚东南部成年糖尿病患者中DR的患病率及其相关因素。
方法
对前往马达瓦拉布大学戈巴转诊医院就诊的糖尿病患者进行了一项基于医院的横断面研究。通过眼底和裂隙灯检查筛查DR。采用多因素二元逻辑回归分析确定与DR相关的因素。
结果
本研究共纳入256例患者（144例男性，占56.2%），年龄为50.15±15.71岁。任何类型DR的患病率为19.9%（95%可信区间15.4%-25.3%），轻度非增殖性糖尿病视网膜病变（NPDR）为10.9%（95%可信区间7.6%-15.4%），中度NPDR为5.9%（95%可信区间3.5%-9.5%），重度NPDR为0.9%（95%可信区间0.2%-3.9%），增殖性DR为2.3%（95%可信区间1.0%-5.1%）。糖尿病病程≥10年（调整后比值比[AOR]10.22，95%可信区间1.70-61.44）、中心性肥胖（AOR 5.42，95%可信区间1.38-21.19）、超重/肥胖（AOR 2.65，95%可信区间1.02-6.92）、高密度脂蛋白（HDL）胆固醇水平较低（AOR 5.82，95%可信区间1.86-18.24）、甘油三酯：HDL胆固醇比值中等（AOR 4.13，95%可信区间1.13-15.15）以及居住在城市（AOR 2.84，95%可信区间1.04-7.78）与DR显著相关。
结论
每五名糖尿病患者中就有一人患有DR。社会人口学、人体测量学和血脂因素与DR独立相关。为减轻糖尿病负担，针对已确定的可改变风险因素进行生活方式调整的策略至关重要。
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