Faculty of Medicine, Al-Quds University, Jerusalem, Palestine.
Department of Internal Medicine, Faculty of Medicine, Al-Quds University, Jerusalem, Palestine.
Endocrinol Diabetes Metab. 2024 Jul;7(4):e494. doi: 10.1002/edm2.494.
Although risk factors linked to diabetic retinopathy (DR) among patients with Type 2 diabetes mellitus (T2DM) have been extensively studied globally, the specific determinants of these factors in relation to DR in Palestine are presently not well understood.
This retrospective cross-sectional study included patients who underwent DR screening with a fundus camera (VersaCam a). The study included patients aged ≥18 with T2DM, excluding those with other types of diabetes or a history of malignancies. Univariable and multivariable logistic regressions were used to identify factors associated with DR.
A total of 1163 patients with T2DM were included in this study. Of these, 211 (18.1%) patients were classified in the DR group, 761 (65.4%) in the no DR group and 191 (16.4%) were ungradable. Among the included patients, 434 (37.3%) were male. A secondary level of education or higher and a BMI ≥30 kg/m, compared with <25 kg/m, were independently and inversely associated with DR, with odds ratios (ORs) of 0.46 (p < 0.001) and 0.58 (p = 0.046), respectively. A 5-year increase in the duration of T2DM correlated with 45% higher odds of having DR (p < 0.001). Patients with DR were more likely to have HbA1c >7%, be physically inactive and use insulin, with ORs of 1.63 (p = 0.02), 2.05 (p < 0.001) and 1.53 (p = 0.03), respectively. Age, gender, occupational status, hypertension and hyperlipidaemia were not independent predictors of DR (p < 0.05).
Longer duration of T2DM, HbA1c >7%, physical inactivity and insulin use were all independently associated with the presence of DR. Furthermore, a secondary or higher educational level and obesity demonstrated independent and inverse associations with the development of DR.
尽管全球范围内已经广泛研究了与 2 型糖尿病（T2DM）患者的糖尿病视网膜病变（DR）相关的风险因素，但目前尚不清楚这些因素与巴勒斯坦 DR 之间的具体关系。
本回顾性横断面研究纳入了接受眼底相机（VersaCam a）DR 筛查的患者。研究包括年龄≥18 岁的 T2DM 患者，排除其他类型糖尿病或恶性肿瘤病史的患者。采用单变量和多变量逻辑回归分析确定与 DR 相关的因素。
本研究共纳入 1163 例 T2DM 患者，其中 211 例（18.1%）患者被归类为 DR 组，761 例（65.4%）为非 DR 组，191 例（16.4%）为不可分级组。在纳入的患者中，434 例（37.3%）为男性。与 BMI<25kg/m2 相比，中学或更高学历和 BMI≥30kg/m2 与 DR 呈负相关，优势比（OR）分别为 0.46（p<0.001）和 0.58（p=0.046）。T2DM 病程增加 5 年，DR 的发生风险增加 45%（p<0.001）。DR 患者更有可能 HbA1c>7%、不运动和使用胰岛素，OR 分别为 1.63（p=0.02）、2.05（p<0.001）和 1.53（p=0.03）。年龄、性别、职业状况、高血压和高脂血症与 DR 无独立相关性（p<0.05）。
T2DM 病程较长、HbA1c>7%、不运动和使用胰岛素均与 DR 存在独立相关。此外，中学或更高学历和肥胖与 DR 的发生呈独立负相关。
