Hangil Eye Hospital, Incheon, Republic of Korea; Department of Ophthalmology, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea.
Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea.
J Neurol Sci. 2023 Jul 15;450:120673. doi: 10.1016/j.jns.2023.120673. Epub 2023 May 8.
BACKGROUND/PURPOSE: This study aimed to investigate the association between the time course of type 2 diabetes mellitus (DM) and the development of optic neuritis (ON) in the Korean population aged 20 years and older.
A total of 10,069,044 subjects were included in this study, which utilized stratified random sampling from the national cohort. The hazard ratios (HRs) for incident ON were compared between subjects with normal fasting glucose (NFG) levels, impaired fasting glucose (IFG) levels, patients with new-onset DM, diabetes duration of fewer than 5 years (early DM), and diabetes duration of 5 years or more (late DM). In addition, the HR for incident ON was assessed and stratified into 20 fasting glucose levels.
The cumulative incidence and HR for ON demonstrated a significant increase across the time course of diabetes (adjusted hazard ratio [aHR] = 1.05, 95% confidence interval [CI]: 1.00 to 1.10 for IFG; aHR = 1.31, 95% CI: 1.19 to 1.44 for new-onset DM; aHR = 1.46, 95% CI: 1.32 to 1.60 for early DM; and aHR = 1.92, 95% CI: 1.77 to 2.08 for late DM). Moreover, the HR for ON was 1.71-fold higher in individuals with fasting glucose levels of 132 mg/dL or more compared to those with levels below 75 mg/dL.
In this nationwide cohort study, the risk of ON was found to increase with the time course of diabetes and elevated glucose levels. These results suggest that efforts to regulate glucose levels and prevent DM progression could reduce the risk of ON.
背景/目的：本研究旨在探讨韩国 20 岁及以上人群 2 型糖尿病（DM）病程与视神经炎（ON）发病的相关性。
本研究共纳入 10069044 名受试者，采用全国队列的分层随机抽样。比较空腹血糖正常（NFG）、空腹血糖受损（IFG）、新发糖尿病、病程<5 年（早期 DM）和病程≥5 年（晚期 DM）患者的新发 ON 发生率的危险比（HR）。此外，还评估了新发 ON 的 HR，并按 20 个空腹血糖水平进行分层。
随着糖尿病病程的进展，ON 的累积发生率和 HR 呈显著增加（校正后的 HR[ aHR]：IFG 为 1.05，95%置信区间[ CI]：1.00 至 1.10；新发 DM 为 1.31，95% CI：1.19 至 1.44；早期 DM 为 1.46，95% CI：1.32 至 1.60；晚期 DM 为 1.92，95% CI：1.77 至 2.08）。此外，空腹血糖水平为 132mg/dL 或以上的个体发生 ON 的 HR 是空腹血糖水平低于 75mg/dL 的个体的 1.71 倍。
在这项全国性队列研究中，发现 ON 的风险随着糖尿病和血糖升高的病程而增加。这些结果表明，控制血糖水平和预防 DM 进展的努力可能会降低 ON 的风险。
