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2型糖尿病患者动脉粥样硬化性心血管疾病风险评分与糖尿病视网膜病变潜在关联的调查:一项横断面研究

Investigation of the Potential Association Between Atherosclerotic Cardiovascular Disease Risk Score and Diabetic Retinopathy in Patients with Type 2 Diabetes: A Cross-Sectional Study.

作者信息

Agapitou Chrysa, Sergentanis Theodoros N, Papageorgiou Effie G, Theodossiadis Panagiotis, Ikonomidis Ignatios, Lambadiari Vaia, Chatziralli Irini

机构信息

2nd Department of Ophthalmology, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece.

Department of Public Health Policy, School of Public Health, University of West Attica, 12243 Athens, Greece.

出版信息

Biomedicines. 2025 Mar 5;13(3):633. doi: 10.3390/biomedicines13030633.

Abstract

: To examine the association between diabetic retinopathy (DR) and the atherosclerotic cardiovascular disease (ASCVD) risk score using the "ASCVD Risk Estimator Plus" tool in patients with type 2 diabetes mellitus (DM) and to assess risk factors potentially associated with DR. : Participants in the study included 181 patients with type 2 DM who underwent a thorough ophthalmic examination, including a best-corrected visual acuity (BCVA) measurement, a dilated fundoscopy, fundus photography, an optical coherence tomography (OCT), and an OCT-angiography (OCT-A). DR was graded as no apparent retinopathy (NDR), mild non-proliferative (NPDR), moderate NPDR, severe NPDR, or proliferative DR (PDR). In addition, a detailed medical history of patients was recorded, while the "ASCVD Risk Estimator Plus" tool by the American College of Cardiology was used to calculate the ASCVD risk. : The ASCVD score, derived by the "ASCVD Risk Estimator Plus", was not found to be significantly correlated with DR ( = 0.191). Multivariable logistic regression analysis showed that factors associated with DR independently included DM duration (multivariable OR = 3.16, 95% CI: 1.55-6.44, = 0.002), HbA1c levels (multivariable OR = 2.94, 95% CI: 1.37-6.32, = 0.006), and the presence of neuropathy (multivariable OR = 3.59, 95% CI: 1.43-9.05, = 0.007). In the multivariable multinomial logistic regression analysis, NPDR development was associated with duration of DM (multivariable RR = 3.31, 95% CI: 1.57-6.97, = 0.002), HbA1c levels (multivariable RR = 2.24, 95% CI: 1.00-5.02, = 0.050), and neuropathy (multivariable RR: 3.94, 95% CI: 1.54-10.11, = 0.004), while PDR development was only associated with HbA1c levels (multivariable RR = 6.88, 95% CI: 2.19-21.63, = 0.001). : The ASCVD score, as it was calculated using the "ASCVD Risk Estimator Plus" tool, was not found to be significantly associated with DR. Factors significantly associated with DR were DM duration, HbA1c levels, and the presence of neuropathy.

摘要

使用“ASCVD风险评估增强版”工具研究2型糖尿病(DM)患者糖尿病视网膜病变(DR)与动脉粥样硬化性心血管疾病(ASCVD)风险评分之间的关联,并评估可能与DR相关的危险因素。:该研究的参与者包括181例2型DM患者,他们接受了全面的眼科检查,包括最佳矫正视力(BCVA)测量、散瞳眼底镜检查、眼底摄影、光学相干断层扫描(OCT)和OCT血管造影(OCT-A)。DR分为无明显视网膜病变(NDR)、轻度非增殖性(NPDR)、中度NPDR、重度NPDR或增殖性DR(PDR)。此外,记录了患者的详细病史,同时使用美国心脏病学会的“ASCVD风险评估增强版”工具计算ASCVD风险。:通过“ASCVD风险评估增强版”得出的ASCVD评分与DR无显著相关性(=0.191)。多变量逻辑回归分析显示,与DR独立相关的因素包括DM病程(多变量OR=3.16,95%CI:1.55-6.44,=0.002)、糖化血红蛋白(HbA1c)水平(多变量OR=2.94,95%CI:1.37-6.32,=0.006)和神经病变的存在(多变量OR=3.59,95%CI:1.43-9.05,=0.007)。在多变量多项逻辑回归分析中,NPDR的发生与DM病程(多变量RR=3.31,95%CI:1.57-6.97,=0.002)、HbA1c水平(多变量RR=2.24,95%CI:1.00-5.02,=0.050)和神经病变(多变量RR:3.94,95%CI:1.54-10.11,=0.004)相关,而PDR的发生仅与HbA1c水平相关(多变量RR=6.88,95%CI:2.19-21.63,=0.001)。:使用“ASCVD风险评估增强版”工具计算的ASCVD评分与DR无显著关联。与DR显著相关的因素是DM病程、HbA1c水平和神经病变的存在。

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