Stolk R P, Vingerling J R, de Jong P T, Dielemans I, Hofman A, Lamberts S W, Pols H A, Grobbee D E
Department of Epidemiology and Biostatistics, Erasmus University Medical School, Rotterdam, The Netherlands.
Diabetes. 1995 Jan;44(1):11-5. doi: 10.2337/diab.44.1.11.
We studied the association between retinopathy and glucose metabolism in a population-based study of elderly men and women. Glucose metabolism was assessed by serum fructosamine and a nonfasting oral glucose tolerance test, and retinopathy was evaluated by fundus photography. Retinopathy was present in 296 of 6,191 subjects examined (4.8%; 120 men and 176 women). Serum glucose and fructosamine levels were higher in subjects with retinopathy compared with those without (8.4 vs. 6.8 mmol/l and 329.8 vs. 308.5 mumol/l, respectively, P < 0.001). Two-hour postload insulin levels and insulin resistance, assessed by the ratio of postload insulin over postload glucose level, did not differ between the two groups. These associations were similar in men and women and in subjects with and without diabetes and did not change after adjustment for body mass index or systolic blood pressure. Within the group of subjects who had retinopathy, serum glucose was significantly associated with the number of hemorrhages. These findings suggest that the presence and severity of retinopathy are associated with higher serum glucose levels, both in subjects with and without diabetes.
在一项针对老年男性和女性的基于人群的研究中，我们研究了视网膜病变与葡萄糖代谢之间的关联。通过血清果糖胺和非空腹口服葡萄糖耐量试验评估葡萄糖代谢，通过眼底摄影评估视网膜病变。在6191名接受检查的受试者中，有296人存在视网膜病变（4.8%；男性120人，女性176人）。与无视网膜病变的受试者相比，有视网膜病变的受试者血清葡萄糖和果糖胺水平更高（分别为8.4 vs. 6.8 mmol/l和329.8 vs. 308.5 μmol/l，P < 0.001）。通过负荷后胰岛素水平与负荷后葡萄糖水平的比值评估的两小时负荷后胰岛素水平和胰岛素抵抗在两组之间没有差异。这些关联在男性和女性、有糖尿病和无糖尿病的受试者中相似，并且在调整体重指数或收缩压后没有变化。在患有视网膜病变的受试者组中，血清葡萄糖与出血数量显著相关。这些发现表明，无论有无糖尿病，视网膜病变的存在和严重程度都与较高的血清葡萄糖水平相关。
