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目的评估2型糖尿病患者视网膜病的危险因素。方法纳入257例2型糖尿病患者,通过眼底检查以及眼底荧光素造影诊断视网膜病,通过问卷调查、临床检查和实验室化验确定各种危险因素暴露情况,对伴和不伴视网膜病的糖尿病患者进行比较。结果糖尿病性视网膜病的患病率为26.8%。多变量logistic回归分析显示,糖尿病病程更长(OR 1.07,95%CI1.03～1.11)、接受胰岛素治疗(OR 2.14,95%CI 1.19～3.85)、非空腹血糖增高(OR 1.07,95%CI 1.00～1.15)和微量白蛋白尿(OR 1.89,95%CI 1.28～2.81)是糖尿病性视网膜病的独立危险因素。进一步分析显示,极低水平的微量白蛋白尿与视网膜病风险即存在显著独立相关性。结论糖尿病病程、胰岛素治疗、血糖水平增高和微量白蛋白尿与2型糖尿病患者的视网膜病有关,极低水平的微量白蛋白尿可以作为预测2型糖尿病患者视网膜病风险的有效工具。
Objective To evaluate the risk factors of retinopathy in type 2 diabetic patients. Methods A total of 257 patients with type 2 diabetes mellitus (T2DM) were enrolled in this study. Retinopathy was diagnosed by fundus examination and fundus fluorescein angiography. The risk factors of exposure were determined by questionnaires, clinical tests and laboratory tests. Diabetic patients with and without retinopathy Compare Results The prevalence of diabetic retinopathy was 26.8%. Multivariable logistic regression analysis showed that the duration of diabetes was longer (OR 1.07, 95% CI 1.03-1.11), insulin treatment (OR 2.14, 95% CI 1.19-3.85) and non-fasting glucose (OR 1.07, 95% CI 1.00-1.15) and microalbuminuria (OR 1.89, 95% CI 1.28-2.81) were independent risk factors for diabetic retinopathy. Further analysis revealed that there was a significant independent association between very low levels of microalbuminuria and the risk of retinopathy. Conclusions Diabetes duration, insulin therapy, elevated blood glucose levels and microalbuminuria are associated with retinopathy in patients with type 2 diabetes, and very low levels of microalbuminuria may be useful tools for predicting the risk of retinopathy in patients with type 2 diabetes.