镰状细胞性状或镰状细胞病与糖尿病视网膜病变风险增加相关。
Sickle Cell Trait or Sickle Cell Disease Associated with Increased Diabetic Retinopathy Risk.
作者信息
Ambrosino Christina M, McDonald Jacinta A, Li Ximin, Nampomba Ann, Scott Adrienne W
机构信息
Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland.
Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota.
出版信息
Ophthalmol Sci. 2025 Feb 28;5(4):100756. doi: 10.1016/j.xops.2025.100756. eCollection 2025 Jul-Aug.
OBJECTIVE
This study aimed to understand the impact of sickle cell disease (SCD) or sickle cell trait (SCT) on diabetic retinopathy and retinopathy treatment burden.
DESIGN
Cross-sectional study.
SUBJECTS AND CONTROLS
Utilizing the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight), 3742 patients with comorbid diabetes mellitus (DM) and either SCD or SCT were included in the analytic sample. A race-stratified group of 3742 patients with DM and no known SCD was included as controls.
METHODS
Data analysis was performed using R (R Project 4.2.0). Descriptive statistics summarized demographic data among patients with comorbid SCD or SCT and among controls. Chi-square tests compared clinical outcomes (proliferative diabetic retinopathy [PDR], diabetic macular edema [DME]) and ocular procedure frequency across patients with DM and SCD or SCT and across controls. Multivariate logistic regression models examined the likelihood of clinical outcomes and ocular procedures across patients with and without comorbid SCD or SCT while adjusting for insurance, smoking status, and demographic factors.
MAIN OUTCOME MEASURES
Frequency of clinical outcomes and ocular procedures.
RESULTS
All measured clinical outcomes were more frequently documented among patients with DM and either SCD or SCT as compared with those with DM alone. Of the 7 ocular procedures studied, 5 were more common among the DM with SCT or SCD group as compared with controls ( < 0.001). On regression analysis, DM patients with comorbid SCD or SCT had 7.36 and 4.22 times greater odds of PDR and DME, respectively (confidence interval for PDR: 6.36-8.54, confidence interval for DME: 3.68-4.85).
CONCLUSIONS
This analysis suggests that DM patients with comorbid SCD or SCT have an increased likelihood of DM-related microvascular pathology and a higher ocular treatment burden. Prospective studies are needed to further characterize the relationship between DM and SCT or SCD.
FINANCIAL DISCLOSURES
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
目的
本研究旨在了解镰状细胞病（SCD）或镰状细胞性状（SCT）对糖尿病视网膜病变及视网膜病变治疗负担的影响。
设计
横断面研究。
研究对象与对照组
利用美国眼科学会IRIS®注册库（视力智能研究），3742例患有糖尿病（DM）合并SCD或SCT的患者被纳入分析样本。一组按种族分层的3742例患有DM且无已知SCD的患者作为对照组。
方法
使用R（R项目4.2.0）进行数据分析。描述性统计总结了合并SCD或SCT的患者以及对照组的人口统计学数据。卡方检验比较了患有DM合并SCD或SCT的患者与对照组的临床结局（增殖性糖尿病视网膜病变[PDR]、糖尿病性黄斑水肿[DME]）和眼科手术频率。多变量逻辑回归模型在调整保险、吸烟状况和人口统计学因素的同时，检验了合并或未合并SCD或SCT的患者出现临床结局和进行眼科手术的可能性。
主要观察指标
临床结局和眼科手术的频率。
结果
与仅患有DM的患者相比，所有测量的临床结局在患有DM合并SCD或SCT的患者中记录得更为频繁。在所研究的7种眼科手术中，与对照组相比，5种在患有SCT或SCD的DM患者中更为常见（<0.001）。回归分析显示，合并SCD或SCT的DM患者发生PDR和DME的几率分别高7.36倍和4.22倍（PDR的置信区间：6.36 - 8.54，DME的置信区间：3.68 - 4.85）。
结论
该分析表明，合并SCD或SCT的DM患者发生DM相关微血管病变的可能性增加，且眼科治疗负担更高。需要进行前瞻性研究以进一步明确DM与SCT或SCD之间的关系。
财务披露
在本文末尾的脚注和披露中可能会找到专有或商业披露信息。
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