社区糖尿病视网膜病变流行病学1.5a随访结果

目的：调查沈阳市风雨坛社区2型糖尿病(type 2 diabetes mellitus， T2DM)人群中糖尿病视网膜病变(diabetic retinopathy， DR)患病率及相关危险因素。

方法：2011年筛查社区T2DM患者457例，2013年复查其中的92例，并新增312例T2DM患者，调查其基本情况及生活方式，并进行糖尿病视网膜病变筛查，运用Logistic多元回归分析相关危险因素。

结果：风雨坛社区2011年和2013年DR患病率分别为15.8%和41.2%。DR与NDR组比较，年龄、DM家族史、DM病程、空腹和餐后2h血糖、糖化血红蛋白(HbA1c)、总胆固醇(TC)、血清肌酐(Scr)、收缩压(SBP)及高、低密度脂蛋白胆固醇(HDL-C、LDL-C)差异有统计学意义(P<0.05)。Logistic回归分析表明：年龄、DM病程、HbA1c、SBP及HDL-C是DR的独立危险因素。2013年参与复查的92例DM患者，DR进展和新发共31例(33.7%)，主要与血糖控制不良有关。

结论：风雨坛社区居民DR患病率远高于我国北方的其他研究，主要与患者DM病程长、血糖控制不良、对DM及其眼病的重视程度不够以及高血压、高血脂等全身疾病的共同作用相关。

Result of 1.5a follow-up for epidemiology of diabetic retinopathy in community

AIM: To investigate the prevalence rate and risk factors of diabetic retinopathy(DR)in type 2 diabetes mellitus(T2DM)in Fengyutan community in Shenyang.

METHODS: Totally 457 community residents with T2DM were selected in 2011. Ninety-two of these people accepted the reexamination in 2013. Besides, there were 312 residents with T2DM joined in the study in the same year. Basic condition and life style were investigated, and diabetic retinopathy screening were performed. Logistic multiple regression was used to analyze related risk factors.

RESULTS: The prevalence of DR were 15.8% and 41.2% in 2011 and 2013 respectively in the community. Compared with NDR group, age, family history of DM, duration of DM, fasting blood-glucose(FBG), 2h post-meal blood glucose(2hPG), hemoglobin A1c(HbA1c), total cholesterol(TC), serum creatinine(Scr), systolic blood pressure(SBP), high- and low-density lipoprotein cholesterol(HDL-C, LDL-C)were statistically significant(P<0.05). The result of logistic regression showed that age, duration of DM, HbA1c, SBP and HDL-C were independent risk factors of DR. There were 31 new sufferers in 92 reexamined patients(33.7%)in 2013 and the main aetiological agent was poor glycemic control.

CONCLUSION: The prevalence of DR in Fengyutan community was much higher than the other studies in northern China. It was primarily concerned with long duration of DM, poor glycemic control, inadequate concern with or even neglect of DM and the related oculopathy, hypertension and hyperlipidemia and so on.