糖尿病视网膜病变危险因素分析

目的：探索糖尿病视网膜病（DR）的主要危险因素。方法：在2018年7月至10月间采用方便抽样方法选取乐清市象阳社区2型糖尿病（DM）人群，由专业调查人员严格按照具体标准操作规程进行，包括面对面访谈、常规实验室检查和眼科检查。使用多元logistic回归分析筛选DR潜在的危险因素。结果：406例2型DM患者纳入本研究，其中177例（占43.6%）患者被诊断为DR（轻度DR为107例，中度DR为57例，重度DR为13例）。与无DR的患者相比，DM病程为5～9年的受检者DR的概率显著增加8%[OR=1.08，95%CI=0.69～1.67，P=0.008]。同时，HbA1c≥6.5%的患者与HbA1c＜6.5%的患者相比，发生DR的概率增加了16%（OR=1.16，95%CI=0.65～2.06，P=0.002）。结论：2型DM患者应进行DR筛查，尤其是DM病程在5年以上且HbA1c异常者。

Risk factors of diabetic retinopathy

Objective: To investigate the risk factors of diabetic retinopathy (DR). Methods: The current study was conducted in patients with type 2 diabetes mellitus (DM) by means of handy sampling from July to October 2018 in one community of Yueqing County, Wenzhou, China. Face-to-face interview, routine laboratory tests and eye examinations were applied by professional investigators strictly following by the specific standard operation procedures (SOP) of the present study. Multivariable logistic regression models were performed to screen the potential influential factors of DR. Results: Among 406 type 2 DM patients aged 40 years and over, 177 (43.6%) were diagnosed as DR (107 with mild DR, 57 with moderate DR, and 13 with severe DR). As compared with their counterparts, the incidence rate of DR in participants with the duration of DM from 5 to 9 years would like to be significantly increased by 8% [OR=1.08, 95%CI=0.69-1.67, P=0.008]. Meanwhile, patients whose glycosylated hemoglobin A1c (HbA1c) over 6.5% would have additional 16% chance to develop DR (OR=1.16, 95%CI=0.65-2.06, P=0.002) compared with those with HbA1c less than 6.5%. Conclusion: DR screening should be conducted in type 2 DM patients, especially in those with type 2 DM for more than 5 years and with abnormal HbA1c.