Department of Ophthalmology, Honghui Hospital, Xi'an Jiaotong University, Xi'an City 710054, Shaanxi Province, P.R. China.
Department of Neurosurgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an City 710061, Shaanxi Province, P.R. China.
J Clin Neurosci. 2023 Oct;116:112-119. doi: 10.1016/j.jocn.2023.08.025. Epub 2023 Sep 7.
Diabetic retinopathy (DR) is a microvascular complication of diabetes that occurs at high frequencies (more than 20%) during the course of the disease. Therefore, we conducted a meta-analysis of the incidence of stroke in DR to determine whether DR is associated with stroke.
The PubMed, Embase and Cochrane databases were systematically searched from their inception to December 1, 2022. Randomized controlled trials (RCTs) that reported DR and stroke events were included. The pooled risk ratio and 95% confidence interval (CI) were calculated. For the incidences of DR and stroke, risk difference and standard error were measured. Sensitivity analysis was performed to assess whether any single study could affect the overall outcome.
Nine RCTs involving 46,599 patients with diabetes were included in this meta-analysis. The incidence of DR in all patients was 0.29 (95% CI 0.20-0.38). The incidence of any stroke in all patients was 0.03 (95% CI 0.03-0.04). The incidence of any stroke in patients with DR was 0.05 (95% CI 0.04-0.07), significant higher than that in all diabetes patients. The pooled risk ratio of stroke in patients with DR was 2.04 (95% CI 1.25-3.32). The estimated risk ratio of stroke in patients with DR without additional conditions was 1.70 (95% CI 1.43-2.03), which was lower than that in patients with DR with additional conditions (2.29, 95% CI 0.93-5.65).
The presence of DR is associated with an increased risk of stroke. Our findings indicate that DR is an important biomarker for the prediction of stroke, and periodic eye examinations should be conducted for stroke prevention.
糖尿病视网膜病变（DR）是糖尿病的一种微血管并发症，在疾病过程中发生率较高（超过 20%）。因此，我们对 DR 患者发生中风的情况进行了荟萃分析，以确定 DR 是否与中风有关。
系统检索了 PubMed、Embase 和 Cochrane 数据库，检索时间从建库至 2022 年 12 月 1 日。纳入了报告 DR 和中风事件的随机对照试验（RCT）。计算合并的风险比和 95%置信区间（CI）。对于 DR 和中风的发生率，测量风险差和标准误。进行敏感性分析以评估任何单个研究是否会影响总体结果。
纳入了本荟萃分析的 9 项 RCT 共涉及 46599 例糖尿病患者。所有患者的 DR 发生率为 0.29（95%CI 0.20-0.38）。所有患者的任何中风发生率为 0.03（95%CI 0.03-0.04）。DR 患者的任何中风发生率为 0.05（95%CI 0.04-0.07），显著高于所有糖尿病患者。DR 患者的中风合并风险比为 2.04（95%CI 1.25-3.32）。无其他疾病条件的 DR 患者发生中风的估计风险比为 1.70（95%CI 1.43-2.03），低于有其他疾病条件的 DR 患者（2.29，95%CI 0.93-5.65）。
DR 的存在与中风风险增加有关。我们的研究结果表明，DR 是中风预测的一个重要生物标志物，应定期进行眼部检查以预防中风。
