Kumie Getinet, Nigatie Marye, Alamrew Abebaw, Gedifie Solomon, Kassahun Woldeteklehaymanot, Jemal Abdu, Mulugeta Chalie, Ayana Sisay, Ayele Mulat, Shitie Eyob, Gtsadik Belaynesh, Abebe Wagaw, Ashagre Agenagnew, Misganaw Tadesse, Dejazmach Zelalem, Sisay Assefa, Asmare Zelalem, Gashaw Muluken, Getachew Ermias, Gashaw Yalewayker, Tadesse Selamyhun, Abate Biruk Beletew, Kidie Atitegeb Abera, Reta Melesse Abate
Department of Medical Laboratory Science, College of Health Sciences, Woldia University, P.O. box 400, Woldia, Ethiopia.
Department of Medical Laboratory Science, College of Health Sciences, Woldia University, P.O. box 400, Woldia, Ethiopia.
Microvasc Res. 2025 Mar;158:104779. doi: 10.1016/j.mvr.2024.104779. Epub 2024 Dec 26.
BACKGROUND: Diabetes mellitus (DM) is a metabolic abnormality affecting 537 million people worldwide. Poor glycemic control, longer duration, and poor medication adherence increased the risk of DM complications. Comprehensive evidence on the pooled prevalence of microvascular complications in DM patients in Ethiopia is not available. Furthermore, individual study findings for the prevalence of microvascular complications in DM patients, and associated factors were not consistent. OBJECTIVE: This systemic review and meta-analysis aimed to assess the pooled prevalence of microvascular complications in DM patients, and its associated risk factors in Ethiopia. METHODS: Systematic search on Scopus, PubMed, Science Direct electronic database, Google Scholar search engine, and library registration was used to identify relevant studies following reviews and meta-analysis guidelines. Microsoft Excel spreadsheets were used to extract data, and Extracted data was analyzed using STATA software version 17.0. A Sensitivity analysis was conducted to assess the role of each study in the final result and the presence of publication bias was assessed by Egger's test. Heterogeneity across studies was checked by Cochran's Q statistic and I2 statistics and significant heterogeneity was assessed using subgroup analysis. RESULTS: The pooled prevalence of microvascular complications in DM patients was 32.89 % (95 % CI: 28.17-37.60). In addition, the pooled prevalence of retinopathy, neuropathy, and nephropathy in DM patients was 17.16 % (95 % CI: 12-22 %), 10.49 % (95 % CI: 8-13 %) and 11.52 % (95 % CI: 9-15 %) respectively. Age >60 years old (AOR = 1.08 (95%CI = 1.02-1.15), longer duration of DM (AOR = 1.57 (95 % CI = 1.31-1.84), poor glycemic control (AOR = 2.21 (95 % CI = 1.52-2.91), poor adherence to diabetic medications (AOR = 3.61 (95 % CI = 1.83-5.38) and presence of hypertension (AOR = 2.26 (95 % CI = 1.73-2.80) ware associated risk factors for microvascular complications in DM patients. CONCUSSION: Around one-third of DM patients had one or more microvascular complications. Patients with advanced age, longer duration of DM, poor glycemic control, poor medication adherence, and comorbidity like hypertension should be targeted to tackle the occurrence and severity of microvascular complications in DM patients. PROTOCOL REGISTRATION: The review protocol was developed and was registered with PROSPERO registration number (CRD42023486459).
背景：糖尿病（DM）是一种代谢异常疾病，全球有5.37亿人受其影响。血糖控制不佳、病程较长以及药物依从性差会增加糖尿病并发症的风险。目前尚无关于埃塞俄比亚糖尿病患者微血管并发症合并患病率的综合证据。此外，关于糖尿病患者微血管并发症患病率及其相关因素的个体研究结果并不一致。 目的：本系统评价和荟萃分析旨在评估埃塞俄比亚糖尿病患者微血管并发症的合并患病率及其相关危险因素。 方法：按照综述和荟萃分析指南，通过对Scopus、PubMed、Science Direct电子数据库、谷歌学术搜索引擎进行系统检索，并进行图书馆注册，以确定相关研究。使用Microsoft Excel电子表格提取数据，并使用STATA软件17.0版对提取的数据进行分析。进行敏感性分析以评估每项研究在最终结果中的作用，并通过Egger检验评估发表偏倚的存在情况。通过Cochran's Q统计量和I²统计量检查研究间的异质性，并使用亚组分析评估显著异质性。 结果：糖尿病患者微血管并发症的合并患病率为32.89%（95%置信区间：28.17 - 37.60）。此外，糖尿病患者视网膜病变、神经病变和肾病的合并患病率分别为17.16%（95%置信区间：12 - 22%）、10.49%（95%置信区间：8 - 13%）和11.52%（95%置信区间：9 - 15%）。年龄>60岁（比值比=1.08（95%置信区间=1.02 - 1.15）、糖尿病病程较长（比值比=1.57（95%置信区间=1.31 - 1.84）、血糖控制不佳（比值比=2.21（95%置信区间=1.52 - 2.91）、糖尿病药物依从性差（比值比=3.61（95%置信区间=1.83 - 5.38）以及存在高血压（比值比=2.26（95%置信区间=1.73 - 2.80）是糖尿病患者微血管并发症的相关危险因素。 结论：约三分之一的糖尿病患者患有一种或多种微血管并发症。应针对年龄较大、糖尿病病程较长、血糖控制不佳、药物依从性差以及患有高血压等合并症的患者，以应对糖尿病患者微血管并发症的发生和严重程度。 方案注册：本综述方案已制定并在PROSPERO注册，注册号为（CRD42023486459）。
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