2型糖尿病患者视网膜病变与贫血的关系

目的探讨2型糖尿病(T2DM)患者糖尿病视网膜病变(DR)与贫血之间的关系。方法对2009例T2DM患者进行体脂参数、血压、血糖、血脂、血红蛋白、C反应蛋白(CRP)、24h尿微量白蛋白等测定,同时进行眼底检查。根据眼底检查结果分为无DR(NDR)组和DR组。依据国内的贫血标准分为贫血组和非贫血组。分析贫血与DR发生率的相关性。结果 T2DM患者中,贫血组的DR发生率显著高于无贫血组(P<0.01),DR组的贫血发生率显著高于NDR组(P<0.01)。Logistic回归分析显示,在校正性别、年龄、病程、体质指数、血脂、糖化血红蛋白(HbA1c)、收缩压、舒张压、CRP、24h尿微量白蛋白等因素后,贫血是DR的独立危险因素(OR=1.952,95%CI为1.273～2.995,P=0.002)。结论贫血是DR发生的一个重要的危险因素。

Relationship between diabetic retinopathy and anemia in patients with type 2 diabetes mellitus

Objective To investigate the relationship between diabetic retinopathy (DR) and anemia in the patients with type 2 diabetes mellitus (T2DM). Methods The case history, physical examination and biochemical tests including body mass index (BMI), blood pressure, serum glucose, hemoglobin, C-reactive protein (CRP) and 24 h-urinary albumin excretion were conducted in 2009 T2DM patients. The patients were divided into non-diabetic retinopathy (NDR) group and DR group based on the results of fundus examination. Anemia was defined according to Chinese anemia criteria. Results The incidence rate of DR was significantly higher in patients with anemia than that in patients without anemia (P<0.01), while the incidence rate of anemia was significantly higher in DR patients than that in NDR patients (P<0.01). Logistic regression analysis showed that, anemia was an independent risk factor of DR (OR=1.952, 95%CI: 1.273-2.995, P=0.002) after adjustment for sex, age, diabetic duration, BMI, plasma lipid status, glycosylated hemoglobin (HbA1c), systolic blood pressure (SBP), diastolic blood pressure (DBP), CRP and 24 h-urinary albumin excretion. Conclusion Anemia is a critical risk factor of DR.