北京德胜社区2型糖尿病人群中糖尿病视网膜病变与糖尿病周围神经病变的相关性研究

Association of diabetic retinopathy with diabetic peripheral neuropathy in type 2 diabetic patients： the Beijing Desheng Diabetic Eye Disease Study

目的 分析北京德胜糖尿病眼病研究队列人群中糖尿病视网膜病变（DR）和糖尿病周围神经病变（DPN）的患病情况及相关性.方法 横断面研究.以北京德胜糖尿病眼病研究所收集的2型糖尿病队列人群为研究对象,对年龄30岁以上已确诊为2型糖尿病的患者共1 098例,对受检者进行调查问卷和全身检查.眼部检查包括小孔视力、眼前节检查及散瞳7视野30＆#176;眼底照相.以改良的糖尿病早期治疗研究（ETDRS）方法对DR进行分级.周围神经检查包括10 9尼龙丝（Semmes-Weinstein单丝）、128 Hz音又及Tip-Therm温度浅感觉检测.采用t检验比较正态计量资料组间差异,卡方检验比较计数资料组间差异.采用多变量Logistic回归分析计算比值比（OR）和95％可信区间（CI）并用后退法筛选危险因素.结果 纳入糖尿病患者959例,其中354例（36.9％）患有不同程度DR,523例（54.5％）患有DPN.DR组DPN患病率61.8％,无DR组DPN患病率50.0％,两组间DPN患病率差异有统计学意义（χ^2=13.66,P〈0.01）.Logistic回归分析显示,与DR发生的相关因素包括年龄（OR=1.03,95％CI：1.01-1.06）及性别（男性）[0R=2.32,95％CI（1.51-3.58）],而DPN增加了DR的发病风险（0R=1.5,95％CI：1.12- 2.01）.结论 DPN在糖尿病患者人群中高发,是DR发生的危险因素之一.

Objective To determine the prevalence of diabetic retinopathy （DR） and diabetic peripheral neuropathy （DPN） in the Beijing Desheng Diabetic Eye Disease Study cohort and to investigate the association between DR and DPN.Methods Cross-sectional study in a type 2 diabetic cohort.Questionnaires were collected and physical examinations were performed.Ophthalmologic examinations consisted of visual acuity with pinhole,slit-lamp examination of the anterior segment and seven-field 30° mydriatic fundus photography.The severity of DR was graded using a modified ETDRS method.Peripheral neuropathy examinations included 10-g Semmes-Weinstein monofilament,128-Hz tuning fork and Tip-Therm.Statistical analysis was performed using SPSS software version 19.0.Results A total of 959 patients with type 2 diabetes mellitus were enrolled,among whom 354 （36.9%） had DR and 523 （54.5%） had DPN.The prevalence of DPN was 61.8% in patients with DR and 50% in patients with no DR （χ^2=13.66,P〈0.01）.Logistic regression analysis showed that DR was associated significantly with age （OR=1.03,95%CI：1.01-1.06） and gender （male） （OR=2.32,95%CI：1.51-3.58）,whereas the presence of DPN increased the risk of DR （OR=1.5,95%CI：1.12-2.01）.Conclusions DPN is commonly seen in patients with type 2 diabetes mellitus and increases the risk of DR.