上海社区糖尿病前期及糖尿病人群视网膜病变患病率及相关危险因素分析

Prevalence of and risk factors associated with diabetic retinopath in pre-diabetic and diabetic population in Shanghai community

目的了解上海社区糖尿病前期（IGR）及糖尿病（DM）人群视网膜病变（DR）的患病率及相关危险因素。方法于2005年6月至2006年3月对在上海市华阳及曹杨两个社区代谢综合征现况调查中获得的IGR和DM病人（共1300例）进行DR筛查，将完成调查并具有完整数据的642例病人（DM者391例，IGR者251例）纳入本次分析，其中男312例，女330例，平均年龄（65±13）岁。视网膜病变采用Canon CR—DGi免散瞳眼底照相机拍照法，并根据国际临床糖尿病视网膜病变严重程度的分级标准诊断。结果社区DM病人DR患病率为19．9％（78例），其中轻、中、重度及增殖性DR的患病率依次为12．0％、5．1％、2．3％和0．5％；IGR人群的DR患病率为8．0％（20例）。Logistic回归结果见到糖尿病病程、糖化血红蛋白是DM病人合并DR的独立危险因素。结论上海社区高血糖人群DR的患病率较高，IGR人群已有DR发生。病程长、血糖控制差均可增加DM病人发生DR的危险。

Objective To determine the prevalence and risk factors of diabetic retinopathy （DR） in the Diabetes Mellitus （DM） and impaired glucose regulation （IGR） population in Shanghai Community. Methods DR screening after the epidemiologic study of metabolic syndrome in Huayang and Caoyang Community , Shanghai was conducted among 1300 patients with DM or IGR during June 2005 and March 2006, Digital non-mydriatic fundus photography was performed for each eye in all subjects. Other factors, including diabetes related history, BMI, WHR, fasting plasma glucose, HbAlc, serum lipid and blood pressure were also assessed. 642 patients,312 males and 330 females, aged 65±13, with complete data were enrolled into the analysis. Results The prevalence of DR was 19. 9% in the diabetic population, and the prevalence of mild, moderate, severe non-proliferative retinopathy and proliferative retinopathy was 12. 0% , 5.1% , 2. 3% and 0. 5% , respectively; the prevalence of DR in IGR reached 8.0%. Logistic regression analysis revealed that HbAI c level and diabetes duration were both independently associated with diabetic retinopathy. Conclusion The prevalence of DR was high in both DM and IGR population. Bad blood glucose control and long diabetes duration both increased occurrence of DR.