糖尿病性黄斑水肿与肾功能受损的相关性

目的 探讨糖尿病性黄斑水肿（diabetic macular edema，DME）与肾功能受损及其严重程度的相关性。设计 回顾性病例系列。研究对象 2016年1月至2020年12月北京老年医院内分泌科住院患者中在眼科会诊的2型糖尿病患者1023例。方法 通过调阅病历获得研究对象的年龄、收缩压、舒张压、血肌酐、空腹静脉血血糖、糖化血红蛋白以及尿微量白蛋白。应用CKD-EPI scr(2009)公式计算估算肾小球滤过率（estimated glomerular filtration rate，eGFR)）。eGFR≥90 ml/min/1.73m2为肾功能正常，60~90 ml/min/1.73m2为肾功能受损，﹤60 ml/min/1.73m2为肾功能不全。调取患者立体彩色眼底像、相干光断层扫描图像。根据美国“糖尿病视网膜病变早期治疗小组”标准诊断DME。比较不同eGFR分级组患者DME的发生率，并采用Logistics回归分析黄斑水肿与肾功能受损程度的相关性。主要指标 DME的发生率。结果 120例患者被诊断为DME。DME的发生与eGFR分级相关，肾功能正常、肾功能受损和肾功能不全患者中，DME患者的比例分别为8.30%、20.51%和24.63%，显示随肾功能异常者DME患者比例显著增加（χ2=34.252，P=0.000）。Logistic回归显示肾功能受损、肾功能不全者发生DME的风险分别是肾功能正常者的1.604倍及2.573倍。结论 DME的发生与肾功能受损及其严重程度相关。（眼科，2021, 30： 232-235）

Association of diabetic macular edema with impaired renal function

Objective To investigated the association of diabetic macular edema (DME) with the impaired renal function in a sample of patients with type 2 diabetes. Design Retrospective case series. Participants A total of 1023 patients with type 2 diabetes hospitalized in the Endocrinology Department of Beijing Geriatric Hospital, who were consulted in ophthalmology, from Jan 2016 to Dec 2020. Methods Age, blood pressure, serum creatinine, fasting venous blood glucose, glycosylated hemoglobin and urinary microalbumin were obtained by reviewing the medical records. Estimated glomerular fifiltration rate (eGFR) was assessed using the CKD-EPI formula and graded (normal renal function ≥ 90 mL/min/1.73 m2; impaired renal function, 60~89 mL/min/1.73 m2; and renal inadequacy < 60 mL/min/1.73 m2). Stereoscopic color fundus image and optical coherence tomography image were also reviewed. DME was confirmed according to standard of Early Treatment Diabetic Retinopathy Study. The correlation between stage of eGFR and presence of DME was assessed by Logistic regression. Main Outcome Measures The presence of DME in different eGFR group. Results Of the 1023 patients with type 2 diabetes included, 120 patients had DME. In patients with normal, impaired and impaired renal function, the presence of DME were 8.30%, 20.51% and 24.63% (χ2=34.252, P=0.000). Logistic regression showed that the risk of DME in patients with impaired renal function and renal insufficiency was 1.604 and 2.573 times higher than those with normal renal function. Conclusion DME is associated with impaired renal function and its severity. (Ophthalmol CHN, 2021, 30: 232-235)