Endocrinology and Metabolism Department, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
Department of Ophthalmology, Qingdao West Coast New Area District Hospital, Qingdao, Shandong, China.
Medicine (Baltimore). 2024 May 10;103(19):e38051. doi: 10.1097/MD.0000000000038051.
This study aimed to explore the potential correlation between atherosclerotic cardiovascular disease (ASCVD) and diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM). We enrolled 6540 patients with T2DM who were receiving chronic disease management for hypertension, hyperglycemia, and hyperlipidemia in Chengyang District of Qingdao. Among them, 730 had ASCVD (ASCVD group), which 5810 did not (N-ASCVD group). The results showed significantly higher levels of age, blood glucose, glycosylated hemoglobin (HbA1c), systolic blood pressure, ASCVD family history, female proportion, and DR incidence in the N-ASCVD group. Additionally, the glomerular filtration rate was significantly lower in the ASCVD group. Logistic regression analysis revealed a positive correlation between DR and ASCVD risk. DR was further categorized into 2 subtypes, nonproliferative DR (NPDR) and proliferative DR (PDR), based on e lesion severity. Interestingly, only the PDR was associated with ASCVD. Even after accounting for traditional ASCVD risk factors such as age, sex, and family history, PDR remained associated with ASCVD, with a staggering 718% increase in the risk for patients with PDR. Therefore, there is a strong association between ASCVD and DR in individuals with T2DM, with PDR particularly exhibiting an independent and positive correlation with increased ASCVD risk.
本研究旨在探讨 2 型糖尿病（T2DM）患者中动脉粥样硬化性心血管疾病（ASCVD）与糖尿病视网膜病变（DR）之间的潜在相关性。我们招募了 6540 名在青岛市城阳区接受高血压、高血糖和高血脂慢性病管理的 T2DM 患者。其中，730 例患有 ASCVD（ASCVD 组），5810 例未患有 ASCVD（N-ASCVD 组）。结果显示，N-ASCVD 组患者的年龄、血糖、糖化血红蛋白（HbA1c）、收缩压、ASCVD 家族史、女性比例和 DR 发生率明显较高。此外，ASCVD 组的肾小球滤过率明显较低。Logistic 回归分析显示，DR 与 ASCVD 风险呈正相关。根据病变严重程度，DR 进一步分为非增殖性 DR（NPDR）和增殖性 DR（PDR）。有趣的是，只有 PDR 与 ASCVD 相关。即使考虑到年龄、性别和家族史等传统 ASCVD 风险因素，PDR 仍然与 ASCVD 相关，PDR 患者的 ASCVD 风险增加了惊人的 718%。因此，T2DM 患者中 ASCVD 和 DR 之间存在强烈关联，PDR 尤其与 ASCVD 风险增加呈独立且正相关。
