Alobaid Thamer, Karalliedde Janaka, O'Connell Matthew Dl, Gnudi Luigi, Sheehan Katie, Lim Ka Keat, Ayis Salma
Department of Population Health Sciences, King's College London, London, UK.
Cardiovascular Division, Faculty of Life Science and Medicine, King's College London, London, UK.
J Diabetes Res. 2025 Jan 11;2025:3307594. doi: 10.1155/jdr/3307594. eCollection 2025.
Diabetic nephropathy (DN) and diabetic retinopathy (DR) are serious complications of type 2 diabetes mellitus (T2DM). The reported estimates of prevalence and progression of DN and DR vary widely across studies. We undertook a systematic review and meta-analysis to determine the extent to which these variations in prevalence and progression of DN and DR may relate to different ethnic groups and socioeconomic status (SES). We searched the databases Ovid MEDLINE, Global Health, APA Psych Info, Embase, and PubMed for publications from 2005 to September 2023, based on T2DM and DN or DR, which included patient's ethnicities and SES. Prevalence estimates were summarized by meta-analysis using random effects models for each microvascular complication, stratified by ethnicity and SES. Data on progression was summarized narratively. Twenty-seven studies were included. The overall prevalence of DN was 18% (95% CI: 14%, 22%) with no differences noted by ethnic group. Low economic status and low education levels were associated with a 4% increased risk of DN compared to higher levels. Higher prevalence of DR was noted among the Afro-Caribbeans, 28% (95% CI: 11%, 46%), compared to the White/Caucasian 19% (95% CI: 11%, 27%), and Asian/Indo Asians 25% (95% CI: 9%, 41%). Low-SES populations have a higher prevalence of DR than high-SES populations. The average prevalence was 16% (95% CI: 11%, 22%) among the high economic status group, compared to 25% (95% CI:20%, 30%) for the low economic status. Our study showed that Black ethnicity was associated with a higher risk of progression to end-stage renal disease (ESRD) and diabetic maculopathy compared to other ethnicities. People with high SES had a lower rate of DR progression than those with low SES, odds ratio (OR) (0.63, 95% CI: 53%, 74%). Ethnicity and SES may be associated with differential risk of development and progression of DN and DR. The available evidence was limited by the number of studies and small samples for certain ethnic/socioeconomic groups.
糖尿病肾病（DN）和糖尿病视网膜病变（DR）是2型糖尿病（T2DM）的严重并发症。关于DN和DR患病率及进展情况的报道估计在不同研究中差异很大。我们进行了一项系统综述和荟萃分析，以确定DN和DR患病率及进展情况的这些差异在多大程度上可能与不同种族和社会经济地位（SES）相关。我们在Ovid MEDLINE、Global Health、APA Psych Info、Embase和PubMed数据库中搜索了2005年至2023年9月期间基于T2DM和DN或DR的出版物，这些出版物包括患者的种族和SES。使用随机效应模型对每种微血管并发症的患病率估计进行荟萃分析，并按种族和SES分层。关于进展的数据进行了叙述性总结。纳入了27项研究。DN的总体患病率为18%（95%置信区间：14%，22%），未发现种族差异。与较高水平相比，低经济地位和低教育水平与DN风险增加4%相关。与白人/高加索人19%（95%置信区间：11%，27%）和亚洲/印度亚洲人25%（95%置信区间：9%，41%）相比，非洲加勒比人的DR患病率更高，为28%（95%置信区间：11%，46%）。低SES人群的DR患病率高于高SES人群。高经济地位组的平均患病率为16%（95%置信区间：11%，22%），而低经济地位组为25%（95%置信区间：20%，30%）。我们的研究表明，与其他种族相比，黑人种族进展为终末期肾病（ESRD）和糖尿病性黄斑病变的风险更高。高SES人群的DR进展率低于低SES人群，优势比（OR）为（0.63，95%置信区间：53%，74%）。种族和SES可能与DN和DR发生及进展的不同风险相关。现有证据受到研究数量以及某些种族/社会经济群体样本量小的限制。
