2型糖尿病患者臂-踝脉搏波传导速度与视网膜病变的关系

Correlation between brachial-ankle pulse wave velocity and diabetic retinopathy in type 2 diabetes

目的：研究2型糖尿病患者臂一踝脉搏波传导速度（ba—PW）与糖尿病视网膜病变患病风险的相关性。方法：收集我院内分泌代谢病科门诊的2型糖尿病患者1000例，对其进行问卷调查、体格检查、生化检测、ba-PwV检测、眼底检查．并将ba-Pwv按照三分位分组．分析ba-Pwv水平与糖尿病视网膜病变的相关性。结果：①根据ba-PWV水平按照三分位分组，每组的糖尿病视网膜病变患病率分别为5．6％（18／3191、11．0％（35／319）、14．2％（45／319），组间趋势明显（趋势P=0．0004）。②多元Logiistic回归分析显示，糖尿病视网膜病变与糖化血红蛋白（HbA．。）、糖尿病病程、使用降糖药物治疗呈显著正相关，比值比fOR）分别为1．35、1．07和2．59（均P〈0．001）：与年龄呈显著负相关（OR=0．96，β=-0．04l，P=-0．01）。③校正多种影响因素后，多元Logistic回归分析显示，与下三分位组相比，ba—Pwv位于第2、第3三分位组的糖尿病视网膜病变患病风险显著增高．OR[95％N信区IN（CI）]分别为2．34（1．20～4．57）、2．89（1．33，6．191，趋势P=-0．0091。结论：在2型糖尿病人群中．ba—PWV异常是糖尿病视网膜病变的独立危险因素，且与糖尿病视网膜病变的患病风险密切相关。因此．对ba-PwV的测量可用于评估糖尿病视网膜病变的患病风险。

Objective To study the correlation between brachial-ankle pulse wave velocity （ba-PWV） and diabetic retinopathy in type 2 diabetic patients. Methods This cross-sectional investigational study included 1 000 type 2 diabetic patients who had received non-mydriatic digital fundus photography examination, questionnaire survey, physical examination, blood and urine biochemical tests, and ba-PWV measurement. And the correlation between ba-PWV and diabetic retinopathy was analyzed. Results Subjects were divided into three groups according to ba-PWV tertiles. Compared with patients in the lowest tertile, those in the second and highest tertiles had significantly higher prevalence of diabetic retinopathy （5.6%, 11.0%, and 14.2%, respectively, P for trend=0.000 4）. Multiple Logistic analysis revealed that hemoglobin AIc （HbAIc）, duration of diabetes and use of hypoglycemic drug therapy were positively correlated with prevalence of diabetic retinopathy [odds ratio （0R）=1.35, 1.07 and 2.59, all P〈0.001], while age was inversely correlated with prevalence of diabetic retinopathy （OR=0.96, β=-0.041 ,P=-0.01）. Adjusted Logistic regression analysis revealed that compared with patients in the lowest tertile of ba-PWV, those in the second and highest tertiles had 2.34-fold and 2.89- fold increase of prevalence of diabetic retinopathy, respectively. Conclusions In type 2 diabetic patients, ba-PWV is an independent risk factor of diabetic retinopathy, and has significant correlation with diabetic retinopathy. Therefore, ba- PWV might be a useful marker for evaluating the risk of diabetic retinopathy.