阜宁县50岁及以上2型糖尿病人群轻度视力损伤患病率调查:江苏糖尿病眼病研究

Prevalence of mild visual impairment in type 2 diabetes patients over 50 years old in Funing County:Jiangsu Diabetic Eye Disease Study

目的调查江苏省阜宁县2型糖尿病患者轻度视力损伤的患病率及影响因素。方法以人群为基础的横断面研究,采用整群随机抽样方法,于2019年3月7日至4月20日收集阜宁县疾病预防控制中心慢病中心登记的50岁及以上2型糖尿病人群的一般资料,并由眼科医师和技师现场进行视力和眼部检查。采用国际眼科学会理事会的标准以0.3≤最佳矫正视力<0.8为轻度视力损伤的诊断标准,分析轻度视力损伤的患病率和视力损伤疾病患病情况,采用Logistic回归模型分析轻度视力损伤的影响因素。结果在拟调查的2 067例糖尿病患者中,实际完成1 909例,应答率为92.4%。至少1眼轻度视力损伤者1 146例,患病率为60.00%;轻度视力损伤共1 832眼,占总受检眼数的47.98%。白内障、屈光不正和糖尿病视网膜病变是轻度视力损伤的主要原因,分别占54.90%(896/1 632)、31.61%(515/1 632)和10.19%(166/1 632)。高龄、女性、口服降糖药或注射胰岛素治疗是双眼轻度视力损伤的危险因素。文化程度高、日照时间长和经常锻炼是双眼轻度视力损伤的保护因素。结论轻度视力损伤在2型糖尿病患者中患病率较高,白内障手术、矫正屈光不正可能有助于改善轻度视力损伤。强化血糖控制、加强锻炼和增加户外活动可能减慢轻度视力损伤的进展,防止其发展成为中重度视力损伤。

Objective To investigate the prevalence and influencing factors of mild visual impairment in type 2 diabetic patients aged≥50 years living in Funing County,Jiangsu Province.Methods A population-based cross-sectional study was adopted.Cluster sampling was conducted among diabetic patients aged≥50 years registered in the Chronic Disease Information Center of Funing County Center for Disease Prevention and Control from March 7th to April 20th,2019.General information of selected patients was collected.Visual and ocular examinations on site were performed by ophthalmologists and technicians.The International Council of Ophthalmology standard for mild visual impairment,0.3≤best corrected visual acuity<0.8 was adopted.The influencing factors of mild visual impairment were analyzed by logistic regression.This study protocol was approved by the Ethics Committee of Affiliated Hospital of Nantong University(No.2014-071).Results Among the included 2067 patients,1909 cases completed the investigation,with a response rate of 92.4%.There were 1146 patients with mild visual impairment in at least one eye,and the prevalence of mild visual impairment was 60.00%.Among the eyes examined,1832 eyes were with mild visual impairment,accounting for 47.98%.Cataract(896/1632),refractive error(515/1632)and diabetic retinopathy(166/1632)were the main causes of mild visual impairment in diabetic patients,accounting for 54.90%,31.61%and 10.19%,respectively.Aging,female gender,low educational attainment,oral hypoglycemic drugs or subcutaneous insulin injection were risk factors for mild visual impairment in both eyes.Higher educational attainment,more sunshine exposure and exercise were protective factors for mild visual impairment in both eyes.Conclusions The prevalence of mild visual impairment is relatively high in type 2 diabetic patients.Cataract surgery,correction of refractive error may help to improve mild visual impairment.Strengthening blood glucose control,more physical exercise and outdoor activities may slow the progression of mild visual impairment and prevent it from moderate and severe visual impairment.