摘要
目的分析上海市延吉社区2型糖尿病患者糖尿病视网膜病变(diabetic retinopathy,DR)的发病率及其相关的影响因素,为早期预防及干预治疗提供依据。方法选取在2017年7月基线调查中无糖尿病视网膜病变(non-diabetic retinopathy,NDR)的597名研究对象,随访2年后2019年8月再次进行眼底检查,统计2型糖尿病患者DR的发病率。采用1∶2匹配巢式病例对照研究方法,计算各个相关因素OR值及95%可信区间,用Cox回归模型拟合配伍logistic回归模型,探讨DR的影响因素。结果上海市延吉社区2型糖尿病患者DR 2年累积发病率为21.94%,其中轻度非增殖期糖尿病视网膜病变(non proliferatine diabetic retinopathy,NPDR)93人(男性44人,女性49人),中度NPDR 38人(男性20人,女性18人)。多因素分析显示饮酒(OR=2.839,95%CI:1.025~7.859)、糖尿病家族史(OR=3.867,95%CI:1.826~8.188)、空腹血糖(OR=3.648,95%CI:1.668~7.978)、糖化血红蛋白(OR=6.066,95%CI:2.815~13.071)、血压(OR=2.076,95%CI:1.097~3.929)、动脉粥样硬化性心血管疾病史(OR=2.415,95%CI:1.208~4.827)是发生DR的影响因素。结论上海市延吉社区2型糖尿病患者DR 2年累积发病率为21.94%,饮酒、血压、糖尿病家族史、空腹血糖、糖化血红蛋白、动脉粥样硬化性心血管疾病史是DR发病的影响因素。
Objective To analyze the incidence rate of diabetic retinopathy(DR)and its related influencing factors in patients with type 2 diabetes mellitus(T2 DM)in Yanji Community of Shanghai,and to provide evidence for its early prevention and intervention.Methods Five hundred and ninety-seven patients without diabetic retinopathy in the baseline survey in July 2017 were selected as the research subjects.After a follow-up of 2 years,ocular fundus examination was performed again in August 2019 and the incidence rate of DR in the T2 DM patients was calculated.A 1∶2 matched nested case-control study was carried out to calculate the OR value and 95%confidence interval of each single factor.Cox regression model was used to fit compatible logistic regression model,and the factors influencing DR were explored.Results The 2-year cumulative incidence rate of DR in the patients with T2 DM in Yanji Community of Shanghai was 21.94%,of which 93 patients suffered from mild non-proliferative diabetic retinopathy(NPDR)(including 44 males and 49 females)and 38 moderate NPDR(including 20 males and 18 females).Multiple factor analysis showed that drinking(OR=2.839,95%CI:1.025-7.859),family history of diabetes(OR=3.867,95%CI:1.826-8.188),fasting blood glucose(OR=3.648,95%CI:1.668-7.978),glycated hemoglobin A1 C(HbA1 C)(OR=6.066,95%CIP:2.815-13.071),blood pressure(OR=2.076,95%CI:1.097-3.929)and history of atherosclerotic cardiovascular disease(OR=2.415,95%CI:1.208-4.827)were factors influencing the occurrence of DR.Conclusion The2-year cumulative incidence rate of DR in the patients with T2 DM in Yanji Community of Shanghai was 21.94%.Drinking,blood pressure,family history of diabetes,fasting blood glucose,Hb A1 c and history of atherosclerotic cardiovascular disease were factors affecting the incidence of DR.
作者
刘宇
卞鑫
冯建秀
王加红
LIU Yu;BIAN Xin;FENG Jian-xiu;WANG Jia-hong(Yanji Community Health Service Center of Yangpu District,Shanghai 200093,China;School of Medicine,Tongji University,Shanghai 200092,China;Kongjiang Hospital of Yangpu District,Shanghai 200093,China;Yangpu District Eye Disease Prevention and Control Center,Shanghai 200093,China;Yangpu Hospital Affiliated to Tongji University,Shanghai 200090,China)
出处
《实用预防医学》
CAS
2021年第6期679-683,共5页
Practical Preventive Medicine
基金
上海市卫生健康委员会科研课题(201940057)。
关键词
2型糖尿病
糖尿病视网膜病变
影响因素
type 2 diabetes mellitus
diabetic retinopathy
influencing factor
