Zhu X R, Yang F Y, Zhang L, Xie R R, Feng J P, Xin Z, Tian W
Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
Beijing Diabetes Institute, Beijing 100730, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2024 Sep 6;58(9):1324-1330. doi: 10.3760/cma.j.cn112150-20240222-00136.
Diabetic retinopathy (DR) is the most common cause of adult blindness in China. Screening of DR is important for early detection, prevention, and treatment. However, there is still controversy in the research on the prevalence and risk factors of DR in China. This study was designed to evaluate the prevalence of DR and related risk factors in patients with type 2 diabetes mellitus in Beijing City. A cross-sectional survey was conducted in in Dongcheng District and Tongzhou District, Beijing City. Patients with type 2 diabetes aged 18-80 years were selected from four communities, and all subjects underwent questionnaires, physical examinations, laboratory examinations and fundus photography. The logistic regression model was used to analyze the associated factors of DR. A total of 1 531 subjects were included, with the median age of 66 years old and the average age of (65.6±7.4) years old, and the glycosylated hemoglobin level in the subjects was 7.2%±1.3%, and the glycosylated hemoglobin compliance rate was 56.0%(857/1 531). A total of 254 patients with diabetic retinopathy were detected, and the prevalence of DR was 16.6%(254/1 531). Among them, there were 218 cases of non-proliferative diabetic retinopathy and 36 cases of proliferative diabetic retinopathy. Compared with the non-DR group, there were statistically significant differences in fasting blood glucose (-3.74, <0.001), glycosylated hemoglobin(=-10.664, <0.001), urinary microalbumin excretion rate(=-7.767,<0.001), low-density lipoprotein cholesterol(=-2.589, =0.01), and duration of diabetes(=-10.189, <0.001) between the DR group and the non-DR group. Multivariate regression analysis showed that the duration of diabetes (=1.08, 95%: 1.06-1.10, <0.001), glycosylated hemoglobin (=1.38, 95%: 1.23-1.55, <0.001), and FPG (=1.11, 95%: 1.03-1.19, =0.008) were associated factors for DR. In this study, the prevalence of DR in 4 communities of type 2 diabetes in Beijing City was 16.6%. Besides, this study further confirmed that the duration of diabetes, fasting blood glucose levels, and glycosylated hemoglobin are associated factors for DR in patients with type 2 diabetes.
糖尿病视网膜病变(DR)是中国成年人失明的最常见原因。DR筛查对于早期发现、预防和治疗至关重要。然而,中国关于DR患病率及危险因素的研究仍存在争议。本研究旨在评估北京市2型糖尿病患者中DR的患病率及相关危险因素。在北京东城区和通州区进行了一项横断面调查。从四个社区选取年龄在18 - 80岁的2型糖尿病患者,所有受试者均接受问卷调查、体格检查、实验室检查和眼底照相。采用逻辑回归模型分析DR的相关因素。共纳入1531名受试者,中位年龄为66岁,平均年龄为(65.6±7.4)岁,受试者糖化血红蛋白水平为7.2%±1.3%,糖化血红蛋白达标率为56.0%(857/1531)。共检测出254例糖尿病视网膜病变患者,DR患病率为16.6%(254/1531)。其中,非增殖性糖尿病视网膜病变218例,增殖性糖尿病视网膜病变36例。与非DR组相比,DR组与非DR组在空腹血糖(=-3.74,<0.001)、糖化血红蛋白(=-10.664,<0.001)、尿微量白蛋白排泄率(=-7.767,<0.001)、低密度脂蛋白胆固醇(=-2.589,=0.01)和糖尿病病程(=-10.189,<0.001)方面存在统计学显著差异。多因素回归分析显示,糖尿病病程(=1.08,95%可信区间:1.06 - 1.10,<0.001)、糖化血红蛋白(=1.38,95%可信区间:1.23 - 1.55,<0.001)和空腹血糖(=1.11,95%可信区间:1.03 - 1.19,=0.008)是DR的相关因素。在本研究中,北京市4个社区2型糖尿病患者的DR患病率为16.6%。此外,本研究进一步证实糖尿病病程、空腹血糖水平和糖化血红蛋白是2型糖尿病患者DR的相关因素。