Young R J, McCulloch D K, Prescott R J, Clarke B F
Br Med J (Clin Res Ed). 1984 Apr 7;288(6423):1035-7. doi: 10.1136/bmj.288.6423.1035.
In a five year prospective study clinical features associated with the development and progress of retinopathy were sought in 296 randomly selected diabetic men aged 20-59. None had ophthalmoscopically detectable retinopathy initially, but during follow up 66 developed the condition (47 background, 10 exudative, 9 proliferative). Linear logistic analyses (two tailed tests) showed that the initial features independently predictive of retinopathy were duration of diabetes, poor glycaemic control, impotence, and--unexpectedly--heavy alcohol consumption. Poor glycaemic control in the interim and proteinuria at review were also associated with the development of retinopathy. No relation was found with smoking or obesity. Glycaemic control and alcohol consumption were therefore the only aetiologically relevant associations identified. The development of severe retinopathy (exudative and proliferative) showed a particular association with heavy alcohol consumption, occurring in nine of the 70 heavy drinkers (13%) compared with 10 (4.4%) of the rest. Alcohol consumption may be an important independent factor associated predictively with sight threatening diabetic retinopathy.
在一项为期五年的前瞻性研究中，对296名年龄在20至59岁之间随机选取的男性糖尿病患者，探寻与视网膜病变发生及进展相关的临床特征。最初，所有患者经眼底镜检查均未发现视网膜病变，但在随访期间，有66人出现了这种情况（47例为单纯性视网膜病变，10例为渗出性视网膜病变，9例为增殖性视网膜病变）。线性逻辑分析（双侧检验）表明，最初能独立预测视网膜病变的特征包括糖尿病病程、血糖控制不佳、阳痿以及——出人意料的是——大量饮酒。随访期间血糖控制不佳以及复查时出现蛋白尿也与视网膜病变的发生有关。未发现与吸烟或肥胖存在关联。因此，血糖控制和饮酒是仅有的在病因学上具有相关性的关联因素。严重视网膜病变（渗出性和增殖性）的发生与大量饮酒尤其相关，70名大量饮酒者中有9人（13%）出现严重视网膜病变，而其余患者中仅有10人（4.4%）出现。饮酒可能是一个与威胁视力的糖尿病视网膜病变有预测关联的重要独立因素。
