2型糖尿病患者非增殖型糖尿病性视网膜病变的影响因素分析

Factors affecting the risk of non-proliferative diabetic retinopathy among patients with type 2 diabetic mellitus

目的了解2型糖尿病(T2DM)患者非增殖型糖尿病性视网膜病变(NPDR)的影响因素,为预防NPDR提供依据。方法选择2019年12月—2021年5月在山东省济宁市第一人民医院内分泌科就诊的无明显眼部不适的≥18岁T2DM患者为研究对象,收集人口学信息、吸烟、饮酒、糖尿病病史和用药资料;测量身高、体重和血压;实验室检测糖化血红蛋白(HbA1c)、空腹血糖、C肽、血脂和血肌酐;采用免散瞳眼底照相仪检查视网膜病变;采用多因素logistic回归模型分析T2DM患者NPDR的影响因素。结果纳入T2DM患者486例,男性354例,占72.84%;年龄M(QR)为48.00(15.25)岁;糖尿病病程M(QR)为35.00(104.25)个月。检出NPDR 94例,检出率为19.34%。多因素logistic回归分析结果显示,高中及以上学历(OR=0.546,95%CI:0.325~0.918)、糖尿病病程(OR=1.008,95%CI:1.005~1.012)、HbA1c(OR=1.183,95%CI:1.034~1.354)和使用非磺酰脲类胰岛素促泌剂(OR=1.859,95%CI:1.082~3.196)是T2DM患者发生NPDR的影响因素。结论文化程度低、病程长、HbA1c水平控制不佳和使用非磺酰脲类胰岛素促泌剂的T2DM患者NPDR发生风险较高。

ObjectiveTo investigate the factors affecting the development of non-proliferative diabetic retinopathy(NPDR)among patients with type 2 diabetic mellitus(T2DM),so as to provide insights into manangement of NPDR.Methods T2DM patients without obvious eye discomfort at ages of 18 years and older admitted to Department of Endocrinology,Jining No.1 People’s Hospital during the period from December 2019 to May 2021 were enrolled.Participants’demographics,smoking,alcohol consumption,medical history of diabetes and use of medicines were collected,and the height,weight and blood pressure were measured.The levels of glycosylated hemoglobin(HbA1c),fasting blood glucose,blood C-peptide,lipid and creatinine were tested,and retinopathy was examined with a non-mydriatic fundus camera.The factors affecting the development of NPDR were identified among T2DM patients using a multivariable logistic regression model.ResultsA total of 486 T2DM patients were enrolled,including 354 men(72.84%),with a median age of 48.00(15.25)years,and median diabetes duration of 35.00(104.25)months.The prevalence of NPDR was 19.34%among the participants.multivariable logistic regression analysis identified an educational level of senior high school and above(OR=0.546,95%CI:0.325-0.918),duration of diabetes(OR=1.008,95%CI:1.005-1.012),HbA1c(OR=1.183,95%CI:1.034-1.354)and use of non-sulfonylurea insulin secretagogues(OR=1.859,95%CI:1.082-3.196)as factors affecting the risk of NPDR among T2DM patients.Conclusion tients with a low educational level,long duration of diabetes,poor HbA1c control and use of non-sulfonylurea insulin secretagogues.