Klein R, Palta M, Allen C, Shen G, Han D P, D'Alessio D J
Department of Ophthalmology, University of Wisconsin Medical School, Madison, USA.
Arch Ophthalmol. 1997 Mar;115(3):351-6. doi: 10.1001/archopht.1997.01100150353007.
To describe the prevalence at baseline and 4-year incidence of retinopathy and its relation to glycemic control from the time of diagnosis of insulin-dependent diabetes.
Geographically defined population-based study.
Twenty-eight-county area in Wisconsin.
Incipient cohort of children, teenagers, and young adults (n = 354) up to 30 years of age with newly diagnosed insulin-dependent diabetes.
Diabetic retinopathy as determined by gradings from 30 degrees color stereoscopic photographs of the Diabetic Retinopathy Study 7 standard fields.
The prevalence of retinopathy at diagnosis was 1.3%. Four years after diagnosis of diabetes, retinopathy was first identified in 5.1% of our cohort and in 9.7% of those 15 years of age or older. After controlling for age, subjects with a mean glycosylated hemoglobin level of 12% or greater were 3.2 times as likely (95% confidence interval, 1.1-9.9) to have retinopathy present at follow-up as were subjects with a mean glycosylated hemoglobin level of less than 12%.
Population-based data on the frequency and incidence of retinopathy from the time of diagnosis of insulin-dependent diabetes mellitus provided by this study suggest a possible reduction in risk of developing retinopathy in those in whom glycemic control is achieved from the time of diagnosis.
描述胰岛素依赖型糖尿病诊断时视网膜病变的基线患病率和4年发病率及其与血糖控制的关系。
基于地理区域的人群研究。
威斯康星州的28个县地区。
354名年龄在30岁及以下新诊断为胰岛素依赖型糖尿病的儿童、青少年和年轻成年人的初始队列。
根据糖尿病视网膜病变研究7个标准视野的30度彩色立体照片分级确定的糖尿病视网膜病变。
诊断时视网膜病变的患病率为1.3%。糖尿病诊断4年后，我们队列中有5.1%的人首次发现视网膜病变，15岁及以上人群中这一比例为9.7%。在控制年龄因素后，平均糖化血红蛋白水平为12%或更高的受试者在随访时出现视网膜病变的可能性是平均糖化血红蛋白水平低于12%的受试者的3.2倍（95%置信区间，1.1 - 9.9）。
本研究提供的基于人群的胰岛素依赖型糖尿病诊断时视网膜病变的频率和发病率数据表明，从诊断时就实现血糖控制的人群发生视网膜病变的风险可能降低。
