广州市华农社区2型糖尿病患者视网膜病变患病情况及危险因素分析

Analysis of prevalence and risk factors of diabetic retinopathy in type 2 diabetes mellitus patients in Huanong community from Guangzhou

目的探讨广州市华农社区2型糖尿病患者糖尿病视网膜病变(DR)患病率及相关危险因素,为DR的临床防治提供依据。方法选取2022年7月广州市华农社区居民健康档案里诊断为2型糖尿病患者进行调查分析,内容包括患者的基本情况、相关病史资料、实验室检查以及眼部检查等,调查DR及威胁视力的DR患病率,分析影响DR发生、发展的危险因素。结果华农社区DR在糖尿病患者中患病率为17.46%,VTDR的患病率为4.96%,年龄、腰围、糖尿病病程、GHbA1c、甘油三酯、25-羟维生素D[25(OH)D]等指标在非DR和DR组间差异有统计学意义(P<0.05);腰围、糖尿病病程、GHbA1c、总胆固醇、25(OH)D在非VTDR及VTDR组间差异有统计学意义(P<0.05)。多因素分析结果显示:糖尿病病程长,GHbA1c高,腰围增大,25(OH)D减低是DR发生发展的危险因素。结论广州市华农社区DR的危险因素主要是病程长、GHbA1c高、腰围增大、25(OH)D水平减低。

Objective To investigate the prevalence and related risk factors of diabetic retinopathy(DR)in type 2 diabetes mellitus patients in Huanong community from Guangzhou,aiming to provide evidence for clinical prevention and treatment of DR.Methods Patients diagnosed with type 2 diabetes mellitus from the health records of residents from Huanong community in Guangzhou during 2022 were selected in this study.Baseline data,disease history,laboratory and ocular examination results were obtained.The prevalence of DR and vision-threatening DR(VTDR)was investigated.Risk factors of the incidence and progression of DR were analyzed.Results The prevalence rate of DR was 17.46%and 4.96%for VTDR in Huanong community.There were significant differences in age,waist circumference,diabetes duration,glycated hemoglobin(GHbA1c),triglycerides and 25-hydroxyvitamin D between non-DR and DR groups(all P<0.05).Statistical significance was observed in waist circumference,diabetes duration,GHbA1c,total cholesterol and 25-hydroxyvitamin D between non-VTDR and VTDR groups(all P<0.05).Multivariate analysis demonstrated that long duration of diabetes,high GHbA1c,large waist circumference and decrease of 25-hydroxyvitamin D were high risk factors for the development of DR.Conclusion Long duration of diabetes,high GHbA1c,large waist circumference and decrease of 25-hydroxyvitamin D are the main risk factors of DR in Huanong community from Guangzhou.