Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Surgical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
PLoS One. 2023 Jun 8;18(6):e0286627. doi: 10.1371/journal.pone.0286627. eCollection 2023.
Diabetic retinopathy (DR) is the primary retinal vascular complication of diabetes mellitus and a leading cause of visual impairment and blindness. It affects the global diabetic population. In Ethiopia, about one-fifth of diabetic patients were affected by DR, but there were inconsistent finding across studies about the determinants factors of DR. Therefore, we aimed to identify the risk factors for DR among diabetic patients.
We have accessed previous studies through an electronic web-based search strategy using PubMed, Google (Scholar), the Web of Science, and the Cochrane Library with a combination of search terms. The quality of each included article was assessed using the Newcastle Ottawa Assessment Scale. All statistical analyses were carried out using Stata version 14 software. The odds ratios of risk factors were pooled using a fixed-effect meta-analysis model. Heterogeneity was assessed using the Cochrane Q statistics and I-Square (I2). Furthermore, publication bias was detected based on the graphic asymmetry test of the funnel plot and/or Egger's test (p< 0.05).
The search strategy retrieved 1285 articles. After the removal of duplicate articles, 249 articles remained. Following further screening, about 18 articles were assessed for eligibility, of which three articles were excluded because of reporting without the outcome of interest, poor quality, and not full text. Finally, fifteen studies were reviewed for the final analysis. Co-morbid hypertension (HTN) (AOR 2.04, 95%CI: 1.07, 3.89), poor glycemic control (AOR = 4.36, 95%CI: 1.47, 12.90), and duration of diabetes illness (AOR = 3.83, 95%CI: 1.17, 12.55) were found to be confirmed associated factors of diabetic retinopathy.
In this study, co-morbid HTN, poor glycemic control, and longer duration of diabetes illness were found to be the determinant factors of DR. Aggressive treatment of co-morbid HTN and blood glucose, and regular eye screening should be implemented to reduce the occurrence of DR.
The review protocol was registered in the international prospective register of systematic reviews (PROSPERO) with registration number PROSPERO: CRD42023416724.
糖尿病视网膜病变(DR)是糖尿病的主要视网膜血管并发症,也是视力损害和失明的主要原因。它影响全球糖尿病患者。在埃塞俄比亚,大约五分之一的糖尿病患者患有 DR,但关于 DR 的决定因素在不同研究中存在不一致的发现。因此,我们旨在确定糖尿病患者中 DR 的危险因素。
我们通过使用 PubMed、Google(Scholar)、Web of Science 和 Cochrane Library 的电子网络搜索策略,结合搜索词,检索了之前的研究。使用纽卡斯尔-渥太华评估量表评估每篇纳入文章的质量。使用 Stata 版本 14 软件对所有统计分析进行分析。使用固定效应荟萃分析模型对危险因素的比值比进行汇总。使用 Cochrane Q 统计量和 I 平方(I2)评估异质性。此外,根据漏斗图的图形不对称检验和/或 Egger 检验(p<0.05)检测发表偏倚。
搜索策略检索到 1285 篇文章。去除重复文章后,剩余 249 篇文章。进一步筛选后,评估了约 18 篇文章的资格,其中 3 篇因报告无兴趣结局、质量差和非全文而被排除。最后,对 15 项研究进行了综述分析。合并高血压(HTN)(AOR 2.04,95%CI:1.07,3.89)、血糖控制不佳(AOR=4.36,95%CI:1.47,12.90)和糖尿病病程(AOR=3.83,95%CI:1.17,12.55)被确定为糖尿病视网膜病变的确认相关因素。
在这项研究中,合并 HTN、血糖控制不佳和糖尿病病程较长被认为是 DR 的决定因素。应积极治疗合并的 HTN 和血糖,并进行定期眼部筛查,以降低 DR 的发生。
该综述方案已在国际前瞻性系统评价注册库(PROSPERO)中注册,注册号为 PROSPERO:CRD42023416724。