School of Medicine, Tibet University, Lhasa, China.
Department of Endocrinology and Metabolism, People's Hospital of Tibet Autonomous Region, Lhasa, 850000, China.
BMC Endocr Disord. 2024 Aug 2;24(1):139. doi: 10.1186/s12902-024-01668-4.
Diabetic retinopathy (DR) is one of the most common complications of diabetes worldwide. The aim of this study was to assess the prevalence of DR in hospitalized patients with type 2 diabetes (T2DM) in Tibet and to identify risk factors that may influence the occurrence of DR.
This was a cross-sectional study conducted in a third-class hospital in the Tibet Autonomous Region. The prevalence of DR in hospitalized patients with T2DM was measured. Univariate and multivariate logistic regression, restricted cubic spline (RCS) analysis and receiver-operating characteristic curve analysis were used to investigate the risk factors for DR.
The prevalence of DR was 29.3%. The duration of diabetes; concentrations of 25-OH-VitD3, hemoglobin, fasting insulin, alanine aminotransferase, total bilirubin, and creatinine; and HOMA-IR were significantly different between DR patients and non-DR patients (all P < 0.05). Univariate and multivariate logistic regression revealed that a longer duration of diabetes and lower 25-OH-VitD3 levels were associated with increased DR risk. RCS analysis suggested overall positive associations of the duration of diabetes and 25-OH-VitD3 concentrations with DR risk (P nonlinearity < 0.05). The turning points for the duration of diabetes and 25-OH-VitD3 concentrations were 5.1 years and 10.6 ng/mL, respectively. The sensitivity, specificity, and area under the receiver-operating characteristic curve for the combination of the duration of diabetes and 25-OH-VitD3 levels were 79.4%, 69.4% and 0.764, respectively.
Given the high prevalence of DR in hospitalized patients with T2DM in Tibet, vitamin D supplementation seems to be important in the prevention of DR to some degree.
糖尿病视网膜病变（DR）是全球范围内糖尿病最常见的并发症之一。本研究旨在评估西藏地区住院 2 型糖尿病（T2DM）患者中 DR 的患病率，并确定可能影响 DR 发生的危险因素。
这是一项在西藏自治区三级医院进行的横断面研究。测量了住院 T2DM 患者中 DR 的患病率。采用单因素和多因素逻辑回归、限制性立方样条（RCS）分析和受试者工作特征曲线分析来探讨 DR 的危险因素。
DR 的患病率为 29.3%。DR 患者和非 DR 患者的糖尿病病程、25-羟维生素 D3、血红蛋白、空腹胰岛素、丙氨酸氨基转移酶、总胆红素和肌酐浓度以及 HOMA-IR 差异均有统计学意义（均 P<0.05）。单因素和多因素逻辑回归显示，糖尿病病程较长和 25-羟维生素 D3 水平较低与 DR 风险增加相关。RCS 分析表明，糖尿病病程和 25-羟维生素 D3 浓度与 DR 风险呈总体正相关（P 非线性<0.05）。糖尿病病程和 25-羟维生素 D3 浓度的转折点分别为 5.1 年和 10.6ng/ml。糖尿病病程和 25-羟维生素 D3 水平联合检测的敏感性、特异性和受试者工作特征曲线下面积分别为 79.4%、69.4%和 0.764。
鉴于西藏地区住院 T2DM 患者中 DR 的高患病率，维生素 D 补充在一定程度上似乎对预防 DR 很重要。
