Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine; Shanghai Clinical Center for Diabetes; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China.
Clinical Biostatistics Department, Biomedical Informatics Consultants LLC, Potomac, Maryland, USA.
Diabetes Obes Metab. 2023 Sep;25(9):2457-2463. doi: 10.1111/dom.15068. Epub 2023 Jun 23.
To investigate the association between a new composite metric, glycaemia risk index (GRI), and incident diabetic retinopathy (DR).
A total of 1204 adults with type 2 diabetes without DR at baseline were included between 2005 and 2019 from a single centre in Shanghai, China. GRI was obtained from continuous glucose monitoring data at baseline. Cox proportion hazard regression analysis was used to assess the association between GRI and the risk of incident DR.
During a median follow-up of 8.4 years, 301 patients developed DR. The multivariable-adjusted hazard ratios (HRs) for incident DR across ascending GRI quartiles (≤14 [reference], 15 ~ 28, 29 ~ 47 and > 47) were 1.00, 1.05 (95% CI 0.74-1.48), 1.33 (95% confidence interval [CI] 0.96-1.84) and 1.53 (95% CI 1.11-2.11), respectively. For each 1-SD increase in GRI, the risk of DR was increased by 20% (HR 1.20, 95% CI 1.07-1.33) after adjustment for confounders.
In patients with type 2 diabetes, higher GRI is associated with an increased risk of incident DR. GRI has the potential to be a valuable clinical measure, which needs to be further explored in future studies.
探讨新的综合指标血糖风险指数（GRI）与糖尿病视网膜病变（DR）发病的关系。
本研究纳入了 2005 年至 2019 年期间来自中国上海单一中心的 1204 例基线时无 DR 的 2 型糖尿病成人患者。GRI 是从基线时的连续血糖监测数据中获得的。采用 Cox 比例风险回归分析评估 GRI 与 DR 发病风险之间的关系。
在中位 8.4 年的随访期间，301 例患者发生了 DR。GRI 四分位值（Q）升高（Q1：≤14 [参照]，Q2：1528，Q3：2947，Q4：>47）的患者发生 DR 的多变量调整后的风险比（HR）分别为 1.00、1.05（95%可信区间 [CI]：0.741.48）、1.33（95% CI：0.961.84）和 1.53（95% CI：1.112.11）。GRI 每增加 1-SD，DR 的发病风险增加 20%（HR 1.20，95% CI：1.071.33），校正混杂因素后结果仍然成立。
在 2 型糖尿病患者中，较高的 GRI 与 DR 发病风险增加相关。GRI 具有成为有价值的临床指标的潜力，需要在未来的研究中进一步探讨。
