东非国家成年人糖尿病视网膜病变的患病率及其相关因素：一项系统评价和荟萃分析。
Prevalence of diabetic retinopathy and its associated factors among adults in East African countries: A systematic review and meta-analysis.
作者信息
Abuhay Habtamu Wagnew, Tesfie Tigabu Kidie, Alemayehu Meron Asmamaw, Agimas Muluken Chanie, Yismaw Getaneh Awoke, Alemu Gebrie Getu, Derseh Nebiyu Mekonnen, Yirsaw Bantie Getnet
机构信息
Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
出版信息
PLoS One. 2025 Jan 31;20(1):e0316160. doi: 10.1371/journal.pone.0316160. eCollection 2025.
INTRODUCTION
Diabetes mellitus (DM) is one of the most significant public health problems. Globally, one in ten adults has diabetes, and it results in macro- or microvascular complications, such as diabetic retinopathy (DR). It is one of the most prevalent eye complications associated with DM, and it is the main cause of vision loss. Even though East African countries face a growing burden of diabetes and DR, no study depicts the regional prevalence and its associated factors. Therefore, this study aimed to estimate the pooled prevalence of DR and its associated factors among adults in East African countries.
METHODS
We extensively searched PubMed, Embase, Scopus, Google Scholar, and Google for relevant studies. A forest plot was used to estimate the pooled prevalence of diabetic retinopathy using DerSimonian and Laird's random-effects model. We checked publication bias using funnel plots and Egger's regression test. Potential heterogeneity was tested using the I-squared statistic. Subgroup analysis, sensitivity analysis, and meta-regression analysis were also performed. Furthermore, the pooled odds ratios for the associated factors were estimated. The research protocol was registered in PROSPER.
RESULTS
Among the 29 included studies, the estimated pooled prevalence of DR in East African countries was 28% (95% CI 23.0, 33.0). Besides, age ≥60 (OR = 2.88, 95% CI: 1.55, 5.32), body mass index ≥ 25 (AOR = 2.85; 95% CI: 1.69, 4.81; I2 = 85.4%, p < 0.001), and hemoglobin A1c levels ≥7 (OR = 2.48, 95% CI: 1.46, 4.23) were significantly associated with the prevalence of DR.
CONCLUSIONS
The prevalence of DR in East Africa was high, with more than one in four individuals with diabetes developing DR. Besides, advanced age, higher body mass index, and elevated hemoglobin A1c levels were significant factors associated with increased DR prevalence. Therefore, comprehensive diabetes management focusing on optimal glycemic control and healthy weight maintenance is essential to mitigate the problems. Also, the Ministries of Health and policymakers should prioritize and implement targeted strategies to address the identified modifiable risk factors, aiming to reduce the prevalence of DR in the region.
TRIAL REGISTRATION
Systematic review registration: PROSPERO (2024: ID = CRD42024511437). https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024511437.
引言
糖尿病（DM）是最重大的公共卫生问题之一。在全球范围内，每十名成年人中就有一人患有糖尿病，它会导致大血管或微血管并发症，如糖尿病视网膜病变（DR）。它是与糖尿病相关的最常见眼部并发症之一，也是视力丧失的主要原因。尽管东非国家面临着日益加重的糖尿病和糖尿病视网膜病变负担，但尚无研究描述该地区的患病率及其相关因素。因此，本研究旨在估计东非国家成年人中糖尿病视网膜病变的合并患病率及其相关因素。
方法
我们广泛检索了PubMed、Embase、Scopus、谷歌学术和谷歌以获取相关研究。使用森林图，采用DerSimonian和Laird随机效应模型估计糖尿病视网膜病变的合并患病率。我们使用漏斗图和Egger回归检验检查发表偏倚。使用I²统计量检验潜在异质性。还进行了亚组分析、敏感性分析和meta回归分析。此外，估计了相关因素的合并比值比。研究方案已在PROSPER中注册。
结果
在纳入的29项研究中，东非国家糖尿病视网膜病变的估计合并患病率为28%（95%CI 23.0，33.0）。此外，年龄≥60岁（OR = 2.88，95%CI：1.55，5.32）、体重指数≥25（AOR = 2.85；95%CI：1.69，4.81；I² = 85.4%，p < 0.001）以及糖化血红蛋白水平≥7（OR = 2.48，95%CI：1.46，4.23）与糖尿病视网膜病变的患病率显著相关。
结论
东非糖尿病视网膜病变的患病率很高，每四名糖尿病患者中就有一人以上患有糖尿病视网膜病变。此外，高龄、较高的体重指数和升高的糖化血红蛋白水平是与糖尿病视网膜病变患病率增加相关的重要因素。因此，注重最佳血糖控制和维持健康体重的综合糖尿病管理对于缓解这些问题至关重要。此外，卫生部和政策制定者应优先考虑并实施有针对性的策略，以解决已确定的可改变风险因素，旨在降低该地区糖尿病视网膜病变的患病率。
试验注册
系统评价注册：PROSPERO（2024：ID = CRD42024511437）。https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024511437。
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