2型糖尿病患者HbA1c水平与糖尿病视网膜病变DR分期的相关性

Correlation Between HbA1c Level and DR Staging of Diabetic Retinopathy in Patients with Type 2 Diabetes

目的探讨2型糖尿病患者HbA1c水平与糖尿病视网膜病变DR分期的相关性。方法选取2019年11月—2020年8月就诊于承德市中心医院内分泌科,并诊断为2型糖尿病的患者265例,根据眼底检查结果分为非糖尿病视网膜病变(NDR)组(n=156)及糖尿病视网膜病变(DR)组(n=109)。收集两组患者的临床资料包括性别、年龄、糖尿病病程、吸烟史、随机血糖、糖化血红蛋白、血脂、25-羟基维生素D、甲状旁腺激素等。为进一步分析将DR组患者根据HbA1c水平分为两个亚组:HbA1c<10%组;HbA1c≥10%组;比较HbA1c水平与糖尿病视网膜病变DR分期的相关性。结果与NDR组比较,DR组HbA1c水平显著升高[(8.83±1.98)%vs(9.35±1.87)%],差异有统计学意义(P<0.05)。多元Logistic回归分析提示糖尿病病程、HbA1c水平与2型糖尿病患者发生糖尿病视网膜病变独立相关(OR=1.174,95%CI:1.111~1.124;OR=1.234,95%CI:1.021~1.492,P<0.05)。亚组分析结果表明,HbA1c≥10%组(n=35)增殖期(PDR)者较HbA1c<10%组(n=74)明显增多,差异有统计学意义(P<0.05)。结论HbA1c水平与2型糖尿病患者并发糖尿病视网膜病变独立相关。

Objective To investigate the correlation between HbA1c level and DR staging of diabetic retinopathy in patients with type 2 diabetes.Methods Selected 265 patients who were diagnosed with type 2 diabetes in the Endocrinology Department of Chengde Central Hospital from November 2019 to August 2020,and were divided into non-diabetic retinopathy(NDR)group based on the results of fundus examination(n=156)and diabetic retinopathy(DR)group(n=109).The clinical data of the two groups of patients were collected,including gender,age,course of diabetes,smoking history,random blood glucose,glycosylated hemoglobin,blood lipids,25-hydroxyvitamin D,parathyroid hormone,etc.For further analysis,patients in DR group were divided into two subgroups according to HbA1c level:HbA1c<10% group;HbA1c≥10% group;to compare the correlation between HbA1c level and DR staging of diabetic retinopathy.Results Compared with the NDR group,the HbA1c level in the DR group was significantly increased[(8.83±1.98)%vs(9.35±1.87)%],the difference was statistically significant(P<0.05).Multivariate logistic regression analysis indicated that the course of diabetes and HbA1c level were independently related to the occurrence of diabetic retinopathy in patients with type 2 diabetes(OR=1.174,95% CI:1.111~1.124;OR=1.234,95%CI:1.021-1.492,P<0.05).The results of subgroup analysis showed that the number of proliferative phase(PDR)in the HbA1c≥10% group(n=35)was significantly higher than that in the HbA1c<10% group(n=74),and the difference was statistically significant(P<0.05).Conclusion HbA1c level is independ ently related to diabetic retinopathy in type 2 diabetic patients.