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  • Title: [Prevalence and risk factors associated with diabetic retinopathy in Santander. Northern Spain].
    Author: Castillo-Otí JM, Cañal-Villanueva J, García-Unzueta MT, Galván-Manso AI, Callejas-Herrero MR, Muñoz-Cacho P.
    Journal: Aten Primaria; 2020 Jan; 52(1):29-37. PubMed ID: 31109720.
    Abstract:
    OBJETIVE: To assess the prevalence and risk factors associated with diabetic retinopathy (DR) in Cantabria. DESIGN: ross-sectional population based study. LOCATION: Health center of Cantabria. PARTICIANTS: A random sample of 442 patients with type 2 diabetes. MAIN MEASUREMENTS: Non-mydiatric retinography, classifying them according to the International Clinical Diabetic Retinopathy Disease Severity Scale. The analyzed risk factors were: age, gender, age at diabetes onset, duration of diabetes, glycated haemoglobin levels (A1C), treatment of diabetes, blood pressure (systolic and diastolic), serum lipids concentration, body mass index, smoking status, hematocrit, pregnancy, serum vitamin D (25 OH D) levels, nephropathy and cardiovascular events. RESULTS: The prevalence of DR was 8.56% (CI: 5.81-11.32): Mild non-proliferative DR: 5.07% (CI: 2.89-7.25); Moderate non-proliferative DR: 1.38% (CI: 0.17-2.60); Severe non-proliferative DR: 0.27% (CI: 0.006-1.28); proliferative DR: 1.84% (CI: 0.46-3.22). Diabetic macular oedema: 2.30% (CI: 0.77-3.83). Mean age: 70 years, mean diagnostic age: 58.97 years, mean body mass index 29.86, 78.40% patients with hypertension, 67.30% dyslipidemia and median A1C: 6.7%. A deficit of 25 (OH) D was identified in 77% of patients. In the multivariate analysis, treatment of type 2 diabetes, body mass index, duration of diabetes and metabolic control of glycaemia were identified as independent risk factors. CONCLUSIONS: The prevalence of DR, compared with former studies, has decreased to 8.56%; this decrease is associated with the improvement in the control of modifiable risk factors. The associated independent risk factors were: treatment, body mass index, duration and control of diabetes. The variables antihypertensive treatment, cardiovascular events and nephropathy showed predictive value for DR. OBJETIVOS: Evaluar la prevalencia, severidad y factores de riesgo asociados a la retinopatía diabética (RD) en Cantabria. DISEÑO: Estudio transversal de base poblacional. EMPLAZAMIENTO: Centro de salud de Cantabria. PARTICIPANTES: Muestra aleatoria de 442 pacientes con diabetes mellitus tipo 2. MEDICIONES PRINCIPALES: Retinografía no midriática, clasificándolas según la International Clinical Diabetic Retinopathy Disease Severity Scale. Los factores de riesgo estudiados: edad, sexo, edad diagnóstico, años de evolución de la diabetes, grado de control glucémico (HbA1c), tratamiento de la diabetes, control de la tensión arterial, control lipídico, obesidad, tabaquismo, hematocrito bajo, embarazo, déficit de vitamina D, nefropatía y eventos cardiovasculares. RESULTADOS: Prevalencia de RD del 8,56% (IC: 5,81-11,32). RD no proliferativa leve: 5,07% (IC: 2,89-7,25); RD no proliferativa moderada: 1,38% (IC: 0,17-2,60); RD no proliferativa severa: 0,27% (IC: 0,006-1,28); RD proliferativa: 1,84% (IC: 0,46-3,22); edema macular diabético: 2,30% (IC: 0,77-3,83). Edad media: 70 años, edad de diagnóstico 58,97 años; índice de masa corporal 29,86; hipertensos 78,40%; dislipidemia 67,30% y HbA1c mediana 6,76%. El déficit de 25 (OH) D fue del 77%. En el análisis multivariante los factores independientes fueron tratamiento de la diabetes mellitus tipo 2, índice de masa corporal, años de evolución y control de la diabetes. CONCLUSIONES: La prevalencia de RD ha disminuido hasta el 8,56%; esta disminución se asocia a la mejora en el control de los factores de riesgo modificables. Los factores de riesgo asociados de forma independiente fueron: tratamiento, índice de masa corporal, años de evolución y control de la diabetes. Las variables control hipertensión arterial, eventos cardiovasculares y nefropatía también mostraron capacidad predictiva para la RD.
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