Moss S E, Klein R, Klein B E
Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison.
Ophthalmology. 1994 Dec;101(12):1962-8. doi: 10.1016/s0161-6420(94)31076-1.
To investigate the association of alcohol consumption with the incidence and progression of diabetic retinopathy.
The population consisted of a cohort of adult younger-onset (diagnosis received before 30 years of age and taking insulin, n = 439) and older-onset (diagnosis received after 30 years of age, n = 478) persons with diabetes examined from 1984 to 1986 and again from 1990 to 1992. The outcomes were incidence of retinopathy, progression, and progression to proliferative retinopathy. Retinopathy was determined by grading of stereoscopic color fundus photographs. Alcohol consumption was determined by questionnaire and summarized as average or recent consumption. The proportion of heavier drinkers was small, 6% of younger-onset and 4% of older-onset persons.
In the younger-onset group, progression of retinopathy occurred in 62%, 51%, 61%, and 71% of nondrinkers, light, moderate, and heavier drinkers, respectively, based on average intake (P = 0.28). Based on recent intake, 55%, 46%, 63%, and 69% of nondrinkers, light, moderate, and heavier drinkers, respectively, progressed (P = 0.10). A similar trend is seen for incidence of retinopathy, but the sample sizes are small. No association is seen with progression to proliferative diabetic retinopathy. After controlling for age, sex, and glycemia in a logistic regression model, alcohol intake is not associated with progression of retinopathy. In the older-onset group, alcohol intake is not related to the incidence or progression of retinopathy.
Alcohol consumption in moderation (< or = 1 oz/day) does not appear to affect the occurrence of diabetic retinopathy.
研究饮酒与糖尿病视网膜病变的发生及进展之间的关联。
研究人群包括一组成年糖尿病患者队列，其中年轻发病组（30岁之前确诊且使用胰岛素，n = 439）和老年发病组（30岁之后确诊，n = 478），这些患者在1984年至1986年接受检查，并于1990年至1992年再次接受检查。观察指标为视网膜病变的发生率、进展情况以及进展为增殖性视网膜病变的情况。视网膜病变通过立体彩色眼底照片分级来确定。饮酒情况通过问卷调查确定，并总结为平均饮酒量或近期饮酒量。重度饮酒者比例较小，年轻发病组为6%，老年发病组为4%。
在年轻发病组中，根据平均饮酒量，非饮酒者、轻度饮酒者、中度饮酒者和重度饮酒者视网膜病变进展的比例分别为62%、51%、61%和71%（P = 0.28）。根据近期饮酒量，相应比例分别为55%、46%、63%和69%（P = 0.10）。视网膜病变发生率也呈现类似趋势，但样本量较小。未发现与进展为增殖性糖尿病视网膜病变有关联。在逻辑回归模型中控制年龄、性别和血糖后，饮酒量与视网膜病变进展无关。在老年发病组中，饮酒量与视网膜病变的发生或进展无关。
适度饮酒（≤1盎司/天）似乎不会影响糖尿病视网膜病变的发生。
