代谢综合征与糖尿病及糖尿病前期人群糖尿病视网膜病变的相关性分析

目的 研究糖尿病与糖尿病前期人群代谢综合征(MS)与糖尿病视网膜病变(DR)的相关性.方法 在北京市昌平区进行了一项有关慢性疾病和危险因素的健康调查,其中2551人完成了病史采集、体格检查、血脂、血糖等生化指标的测定和眼底检查.将受试对象分为DR组和无DR组(NDR组),将NDR组按HbA1c水平与DR组1∶1进行匹配(NDR组及DR组各74例),进行病例对照研究.进一步将受试对象分为MS组(105例)和无MS组(NMS组,43例),而后进行两组罹患DR的比较分析.结果 DR组和NDR组各项临床和生化指标差异均无统计学意义.然而,罹患DR患者的比例按照符合MS组分个数的增加而呈线性增加(x2=9.938,P=0.037).MS组合并DR的比例明显高于无MS组(x2 =5.540,P=0.019).调整了年龄、性别、腰围、收缩压、总胆固醇、HbA1c和糖尿病病程后,MS是DR的一个独立危险因素(OR =2.948,95％ CI:1.134～7.664,P=0.027).结论 在糖尿病及糖尿病前期人群中,MS与DR明显相关.即使在血糖控制水平一致的情况下,MS仍是DR的独立危险因素.

A study on correlation between metabolic syndrome and diabetic retinopathy in diabetic and pre-dia-betic people

Objective To study the relationship between metabolic syndrome (MS) and diabetic retinopathy (DR) in diabetic and pre-diabetic people.Methods This was a survey on chronic diseases and their risk factors conducted in Changping, Beijing.A total of 2 551 subjects completed the medical history collection, physical examination, laboratory measurements of serum lipid, blood sugar and other biochemical indices, as well as the fundus checking.All subjects were divided into DR group and non-DR (NDR)group.NDR group was matched to DR group by HbA1c in 1∶1 ratio.Therefore, 74 DR patients and 74HbA1c-matched NDR subjects were included in this case control study.All subjects were further divided into MS group (105 subjects) or non-MS group (43 subjects) to analyze the incidence of DR.Results There were no statistical differences between DR group and NDR group in a number of biological or clinical markers.However, the percentage of patients with DR were increased along with the increase of MS constitutes (x2 =9.938, P =0.037).The percentage of patients combined with MS was significantly higher than that in patients without MS (x2 =5.540, P =0.019).MS was an independent risk factor of DR after adjusting for age, sex, waist circumference, systolic blood pressure, total cholesterol, HbA1 c and duration of diabetes (OR =2.948, 95％ CI: 1.134-7.664, P =0.027).Conclusion There is a significant correlation between MS and DR in diabetic and pre-diabetic people.MS is an independent risk factor of DR, even to the same extent of glycemic control.