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Title: [Prevalence and associated factors of diabetic retinopathy among type 2 diabetes in Dongcheng District and Tongzhou District, Beijing City: a cross-sectional study].
Author: Zhu XR, Yang FY, Zhang L, Xie RR, Feng JP, Xin Z, Tian W.
Journal: Zhonghua Yu Fang Yi Xue Za Zhi; 2024 Sep 06; 58(9):1324-1330. PubMed ID: 39290012.
Abstract:
Objective: Diabetic retinopathy (DR) is the most common cause of adult blindness in China. Screening of DR is important for early detection, prevention, and treatment. However, there is still controversy in the research on the prevalence and risk factors of DR in China. This study was designed to evaluate the prevalence of DR and related risk factors in patients with type 2 diabetes mellitus in Beijing City. Methods: A cross-sectional survey was conducted in in Dongcheng District and Tongzhou District, Beijing City. Patients with type 2 diabetes aged 18-80 years were selected from four communities, and all subjects underwent questionnaires, physical examinations, laboratory examinations and fundus photography. The logistic regression model was used to analyze the associated factors of DR. Results: A total of 1 531 subjects were included, with the median age of 66 years old and the average age of (65.6±7.4) years old, and the glycosylated hemoglobin level in the subjects was 7.2%±1.3%, and the glycosylated hemoglobin compliance rate was 56.0%(857/1 531). A total of 254 patients with diabetic retinopathy were detected, and the prevalence of DR was 16.6%(254/1 531). Among them, there were 218 cases of non-proliferative diabetic retinopathy and 36 cases of proliferative diabetic retinopathy. Compared with the non-DR group, there were statistically significant differences in fasting blood glucose (Z=-3.74, P<0.001), glycosylated hemoglobin(Z=-10.664, P<0.001), urinary microalbumin excretion rate(Z=-7.767,P<0.001), low-density lipoprotein cholesterol(Z=-2.589, P=0.01), and duration of diabetes(Z=-10.189, P<0.001) between the DR group and the non-DR group. Multivariate regression analysis showed that the duration of diabetes (OR=1.08, 95%CI: 1.06-1.10, P<0.001), glycosylated hemoglobin (OR=1.38, 95%CI: 1.23-1.55, P<0.001), and FPG (OR=1.11, 95%CI: 1.03-1.19, P=0.008) were associated factors for DR. Conclusion: In this study, the prevalence of DR in 4 communities of type 2 diabetes in Beijing City was 16.6%. Besides, this study further confirmed that the duration of diabetes, fasting blood glucose levels, and glycosylated hemoglobin are associated factors for DR in patients with type 2 diabetes. 目的： 糖尿病视网膜病变（diabetic retinopathy，DR）是导致我国成人盲最常见的原因。DR早期筛查和防治具有重要意义。然而，国内对DR患病率及危险因素研究仍存在争议。本研究旨在评估北京地区2型糖尿病患者中DR患病率及相关因素。 方法： 在北京市东城区和通州区进行整群抽样，共选取4个社区，以辖区里的年龄18~80岁居民中2型糖尿病患者为研究对象进行横断面调查，所有受试者接受问卷调查、体格检查、实验室检查及眼底照相检查。采用logistic回归模型分析DR的关联因素。 结果： 共纳入研究对象1 531例，中位数年龄66岁、（65.6±7.4）岁，受试者中糖化血红蛋白水平为7.2%±1.3%，糖化血红蛋白达标率为56.0%（857/1 531）。检出糖尿病视网膜病变DR 254例，DR患病率为16.6%（254/1 531）。其中非增殖期糖尿病视网膜病变218例，增殖期糖尿病视网膜病变36例。DR组与非DR组相比，空腹血糖（Z=-3.74，P<0.001）、糖化血红蛋白（Z=-10.664，P<0.001）、尿微量白蛋白排泄率（Z=-7.767，P<0.001）、低密度脂蛋白胆固醇（Z=-2.589，P=0.01）、糖尿病病程（Z=-10.189，P<0.001）存在统计学差异。多因素回归分析表明糖尿病病程（OR=1.08，95%CI：1.06~1.10，P<0.001），糖化血红蛋白（OR=1.38，95%CI：1.23~1.55，P<0.001），空腹血浆葡萄糖（每升高1 mmol/L，OR=1.11，95%CI：1.03~1.19，P=0.008）是DR的相关因素。 结论： 北京地区4个社区2型糖尿病人群DR患病率为16.6%。本研究进一步证实糖尿病病程、空腹血糖水平、糖化血红蛋白是2型糖尿病患者发生DR的相关因素。.

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