Nathan D M, Singer D E, Godine J E, Harrington C H, Perlmuter L C
Diabetes. 1986 Jul;35(7):797-801. doi: 10.2337/diab.35.7.797.
Non-insulin-dependent (type II) diabetics over the age of 55 comprise most of the diabetic population and are at considerable risk for the development of both macrovascular and microvascular complications. We studied the prevalence of retinopathy and its association with putative risk factors for its development in an elderly (55- to 75-yr-old) population of type II diabetics. Our cross-sectional analysis revealed that duration of diabetes and hemoglobin A1c (HbA1c) concentration were the two major predictors of the presence of retinopathy. Duration effect was seen after 10 yr of diabetes, whereas HbA1c effect was linear over its entire range. Hypertension, which has been reported to be a risk factor for microvascular disease in younger diabetic patients, was not associated with retinopathy in the older type II population. Multiple logistic regression analysis revealed that both the duration of diabetes and HbA1c remained significant independent determinants of retinopathy even after taking age and blood pressure into account. Our results support an etiologic role for metabolic control in the development of retinopathy in the elderly type II population.
55岁以上的非胰岛素依赖型（II型）糖尿病患者占糖尿病患者群体的大多数，他们发生大血管和微血管并发症的风险相当高。我们研究了老年（55至75岁）II型糖尿病患者视网膜病变的患病率及其与视网膜病变发生的假定危险因素之间的关联。我们的横断面分析显示，糖尿病病程和糖化血红蛋白（HbA1c）浓度是视网膜病变存在与否的两个主要预测因素。糖尿病病程达10年后可见病程效应，而HbA1c效应在其整个范围内呈线性关系。高血压在年轻糖尿病患者中被报道为微血管疾病的危险因素，但在老年II型糖尿病患者中与视网膜病变无关。多元逻辑回归分析显示，即使在考虑年龄和血压因素后，糖尿病病程和HbA1c仍然是视网膜病变的重要独立决定因素。我们的研究结果支持代谢控制在老年II型糖尿病患者视网膜病变发生中的病因学作用。
