Fairchild J M, Hing S J, Donaghue K C, Bonney M A, Fung A T, Stephens M M, Mitchell P, Howard N J, Silink M
Diabetes Complications Assessment Service, Ray Williams Institute of Paediatric Endocrinology, Children's Hospital, Camperdown, NSW.
Med J Aust. 1994 Jun 20;160(12):757-62. doi: 10.5694/j.1326-5377.1994.tb125943.x.
To establish the prevalence of, and risk factors associated with, diabetic retinopathy in an Australian adolescent diabetes clinic population.
A prospective longitudinal study; baseline findings.
Two hundred and fifty-five patients with Type 1 (insulin-dependent) diabetes mellitus assessed by our service were studied. Entry criteria were: age 11.0-19.9 years; diabetes duration of at least two years; and gradable fundus photographs of at least one eye.
The presence and severity of retinopathy, as assessed by the grading of stereoscopic fundus photographs. Possible risk factors assessed were age, sex, diabetes duration, pubertal stage, blood pressure, glycaemic control and total cholesterol level.
The prevalence of retinopathy was 42%; all of those affected had mild background retinopathy. Highly significant associations were found with glycaemic control and both total and prepubertal duration of diabetes. No associations were found with age, sex, pubertal stage, blood pressure or total cholesterol level.
The high prevalence of early diabetic retinopathy in this group of Australian adolescents is comparable to recent reports from other centres. The significant associations with glycaemic control and duration of diabetes provide further strong evidence for the benefit of optimal glycaemic control during adolescence. Our finding that the prepubertal years of diabetes contribute to the development of retinopathy suggests that glycaemic control before puberty should also be optimised. The planned follow-up of this cohort will establish the risk of progression to vision-threatening retinopathy and allow risk factors to be further evaluated.
确定澳大利亚青少年糖尿病诊所人群中糖尿病视网膜病变的患病率及其相关危险因素。
一项前瞻性纵向研究；基线研究结果。
对本机构评估的255例1型（胰岛素依赖型）糖尿病患者进行了研究。入选标准为：年龄11.0 - 19.9岁；糖尿病病程至少两年；至少一只眼睛有可分级的眼底照片。
通过立体眼底照片分级评估视网膜病变的存在和严重程度。评估的可能危险因素包括年龄、性别、糖尿病病程、青春期阶段、血压、血糖控制和总胆固醇水平。
视网膜病变的患病率为42%；所有受影响者均为轻度背景性视网膜病变。发现血糖控制以及糖尿病总病程和青春期前病程与视网膜病变有高度显著相关性。未发现与年龄、性别、青春期阶段、血压或总胆固醇水平有相关性。
这组澳大利亚青少年中早期糖尿病视网膜病变的高患病率与其他中心最近的报告相当。血糖控制和糖尿病病程之间的显著相关性为青春期优化血糖控制的益处提供了进一步的有力证据。我们的研究发现青春期前的糖尿病病程对视网膜病变的发生有影响，这表明青春期前的血糖控制也应优化。对该队列的计划随访将确定进展为威胁视力的视网膜病变的风险，并允许进一步评估危险因素。
