初发2型糖尿病患者视网膜病变与动脉内膜中层厚度的相关性

目的 探讨初发2型糖尿病患者视网膜病变(DR)与颈、股动脉内膜中层厚度(IMT)的关系.方法 选择确诊2型糖尿病且病程在1年以内的患者1236例,其中老年组218例,非老年组1018例.采用GATEwAY2Dfx型彩色多普勒超声仪测定颈、股动脉IMT,并行眼底检查.结果 共检出DR 179例,其中老年DR组36例,非老年DR组143例.老年DR组颈、股动脉IMT为(0.83±0.11)mm和(0.80±0.11)mm,老年对照组为(0.78±0.12)mm和(0.75±0.13)mm,两组比较差异有统计学意义(P＜0.05);非老年DR组颈、股动脉IMT为(0.78±0.13)mm和(0.77±0.13)mm,非老年对照组为(0.72±0.14)mm和(0.71±0.13)mm,两组比较差异有统计学意义(P＜0.01).老年组颈、股动脉IMT≥0.8 mm组DR患病率为21.3%和23.0%,与IMT＜0.8 mm组的8.3%和8.5%比较,差异有统计学意义(P＜0.01);非老年组分别为21.3%、23.0%和8.3%、8.5%,差异有统计学意义(P＜0.01和P＜0.05).以DR为因变量,以年龄、血压、空腹血糖、高密度脂蛋白(HDL-C)、空腹胰岛素(FINS)、颈、股动脉IMT为自变量进行Logistic回归分析,在校正年龄、血脂、胰岛素等因素后,颈、股动脉IMT仍与DR相关(P＜0.01).结论 初发2型糖尿病患者DR与颈、股动脉IMT具有明显的相关性,早期DR改变即与IMT相关.

Relationship between diabetic retinopathy and intima-media thickness in newly diagnosed type 2 diabetes

Objective To explore the relationship between diabetic retinopathy (DR) and intima-media thickness in newly diagnosed type 2 diabetic patients. Methods A total of 1236 diabetic subjects who were diagnosed within 1 year, including 218 older patients, were enrolled in the study. Intima-media thickness of the right common carotid artery and femoral artery were determined using B mode ultrasonography. All subjects were ophthalmologically examined. Results The intima-media thickness values of the carotid artery and femoral artery[(0.83 ± 0.11)mm, (0. 80 ±0.11)mm] in elderly DR group were higher than those [(0. 78±0.12)mm, (0.75±0.13)mm] in elderly non-DR group(P＜0.05). The prevalences of DR in IMT≥0.8 mm group[20.6%: carotid artery, 18.6%: femoral artery] were higher than those in IMT＜ 0.8mm group [13.0%: carotid artery, 13.6%: femoral artery] (P＜0. 05). Logistic regression analysis also showed DR was associated with IMT. Conclusions DR is associated with IMT in newly diagnosed type 2 diabetic patients, and early changes of retinopathy are associated with increased IMT.