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拉丁美洲和加勒比地区糖尿病患者糖尿病视网膜病变的患病率和发病率:系统评价和荟萃分析。

Prevalence and incidence of diabetic retinopathy in patients with diabetes of Latin America and the Caribbean: A systematic review and meta-analysis.

机构信息

Unidad de Investigación Clínica y Epidemiológica, Escuela de Medicina, Universidad Peruana Unión, Lima, Peru.

Instituto Nacional de Oftalmología, Dr. Francisco Contreras Campos, Lima, Peru.

出版信息

PLoS One. 2024 Apr 4;19(4):e0296998. doi: 10.1371/journal.pone.0296998. eCollection 2024.

Abstract

OBJECTIVES

This systematic review aimed to assess the prevalence and incidence of diabetic retinopathy in patients with diabetes of Latin America and the Caribbean.

METHODS

We searched Web of Science (WoS)/Core Collection, WoS/MEDLINE, WoS/Scielo, Scopus, PubMed/Medline and Embase databases until January 16, 2023. We meta-analyzed prevalences according to type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM).

RESULTS

Forty-three prevalence studies (47 585 participants) and one incidence study (436 participants) were included. The overall prevalence of retinopathy in patients with T1DM was 40.6% (95% CI: 34.7 to 46.6; I2: 92.1%) and in T2DM was 37.3% (95% CI: 31.0 to 43.8; I2: 97.7), but the evidence is very uncertain (very low certainty of evidence). In meta-regression, we found that age (T1DM) and time in diabetes (T2DM) were factors associated with the prevalence. On the other hand, one study found a cumulative incidence of diabetic retinopathy of 39.6% at 9 years of follow-up.

CONCLUSIONS

Two out of five patients with T1DM or T2DM may present diabetic retinopathy in Latin America and the Caribbean, but the evidence is very uncertain. This is a major public health problem, and policies and strategies for early detection and opportunely treatment should be proposed.

摘要

目的

本系统评价旨在评估拉丁美洲和加勒比地区糖尿病患者中糖尿病视网膜病变的患病率和发病率。

方法

我们检索了 Web of Science(WoS)/核心集、WoS/MEDLINE、WoS/Scielo、Scopus、PubMed/Medline 和 Embase 数据库,检索时间截至 2023 年 1 月 16 日。我们根据 1 型糖尿病(T1DM)和 2 型糖尿病(T2DM)对患病率进行了荟萃分析。

结果

共纳入 43 项患病率研究(47585 名参与者)和 1 项发病率研究(436 名参与者)。T1DM 患者的视网膜病变总患病率为 40.6%(95%CI:34.7 至 46.6;I2:92.1%),T2DM 为 37.3%(95%CI:31.0 至 43.8;I2:97.7%),但证据极不确定(极低确定性证据)。在元回归中,我们发现年龄(T1DM)和糖尿病病程(T2DM)是与患病率相关的因素。另一方面,一项研究发现,在 9 年的随访中,糖尿病视网膜病变的累积发病率为 39.6%。

结论

在拉丁美洲和加勒比地区,每五名 T1DM 或 T2DM 患者中就有两名可能患有糖尿病视网膜病变,但证据极不确定。这是一个重大的公共卫生问题,应提出早期发现和及时治疗的政策和策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1376/10994322/f7bedad4fc8d/pone.0296998.g001.jpg

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