拉丁裔人群中糖尿病性黄斑水肿与肾功能关系的评估。
Evaluation of the Relationship Between Diabetic Macular Edema and Renal Function in a Latino Population.
作者信息
Torres-Arellano José M, Tornero-Jimenez Andrea, Sánchez-Ríos Alejandra, Olvera-Montaño Oscar, Muñoz-Villegas Patricia
机构信息
Regional Medical Affairs Department, Laboratorios Sophia, S.A. de C.V., Paseo del Norte 5255, Guadalajara Technology Park, 45010, Zapopan, JAL, Mexico.
Instituto de Investigación en Oftalmología y Ciencias Visuales, CUCS, University of Guadalajara, Sierra Mojada 950, 44340, Guadalajara, JAL, Mexico.
出版信息
Ophthalmol Ther. 2023 Oct;12(5):2745-2755. doi: 10.1007/s40123-023-00787-w. Epub 2023 Aug 6.
INTRODUCTION
Diabetic macular edema (DME) is one of the leading causes of vision impairment. The relationship between DME and estimated glomerular filtration rate (eGFR) has not been clearly evaluated in Hispanic or Latino populations. The objective of this study was to evaluate the eGFR in a Latino population with DME.
METHODS
A cross-sectional, observational, and descriptive study was carried out on the basis of a multicenter phase III clinical trial.
RESULTS
A total of 82 subjects diagnosed with DME (36 women and 46 men) were included in the study. The mean age was 61.93 ± 6.71 years. Mean values of the blood chemistry parameters glycated hemoglobin and eGFR were 7.20 ± 0.95% and 74.42 ± 26.82 mL/min/1.73 m, respectively. The time elapsed since diagnosis of diabetes mellitus was 15.30 ± 7.35 years, while the duration of DME was 1.41 ± 1.75 years. Mean values for central macular thickness (CMT) and total macular volume (TMV) were 440.99 ± 132.22 µm and 11.97 ± 2.11 mm, respectively. DME duration had a negative correlation with TMV (Rho - 0.26, p < 0.05) and a positive correlation with mean arterial pressure (Rho 0.26, p < 0.05). CMT was correlated with TMV (Rho 0.43, p < 0.0001) and visual acuity (Rho 0.26, p < 0.05). No significant correlations were observed between eGFR and CMT, TMV, or any demographic variable (p > 0.05). Chronic kidney disease (CKD) was associated with hypertension (OR 9.32, p = 0.035), elevated intraocular pressure (IOP) (OR 0.03, p = 0.011), and advanced age (OR 0.45, p = 0.011). CMT was significantly associated with TMV (β = 27.69, p < 0.0001).
CONCLUSIONS
We did not find a correlation between eGFR and DME. Our findings suggest that the presence of hypertension is associated with a decrease in the GFR < 60 mL/min/1.73 m, and CKD may be associated with advanced age and elevated IOP which may increase the risk for the development of glaucoma.
TRIAL REGISTRATION
NCT05217680 (clinicaltrials.gov).
引言
糖尿病性黄斑水肿（DME）是视力损害的主要原因之一。在西班牙裔或拉丁裔人群中，DME与估计肾小球滤过率（eGFR）之间的关系尚未得到明确评估。本研究的目的是评估患有DME的拉丁裔人群的eGFR。
方法
基于一项多中心III期临床试验进行了一项横断面、观察性和描述性研究。
结果
本研究共纳入82例诊断为DME的受试者（36名女性和46名男性）。平均年龄为61.93±6.71岁。血液化学参数糖化血红蛋白和eGFR的平均值分别为7.20±0.95%和74.42±26.82 mL/min/1.73 m²。自诊断糖尿病以来的时间为15.30±7.35年，而DME的病程为1.41±1.75年。中心黄斑厚度（CMT）和黄斑总体积（TMV）的平均值分别为440.99±132.22 µm和11.97±2.11 mm³。DME病程与TMV呈负相关（Rho -0.26，p<0.05），与平均动脉压呈正相关（Rho 0.26，p<0.05）。CMT与TMV（Rho 0.43，p<0.0001）和视力（Rho 0.26，p<0.05）相关。未观察到eGFR与CMT、TMV或任何人口统计学变量之间存在显著相关性（p>0.05）。慢性肾脏病（CKD）与高血压（OR 9.32，p = 0.035）、眼压升高（IOP）（OR 0.03，p = 0.011）和高龄（OR 0.45，p = 0.011）相关。CMT与TMV显著相关（β = 27.69，p<0.0001）。
结论
我们未发现eGFR与DME之间存在相关性。我们的研究结果表明，高血压的存在与GFR<60 mL/min/1.73 m²的降低相关，并且CKD可能与高龄和眼压升高相关，这可能增加青光眼发生的风险。
试验注册
NCT05217680（clinicaltrials.gov）
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