Risk factors of diabetic retinopathy in type 2 diabetic patients

( views:101, downloads:0 )
Author:
CAI Xiao-ling()
WANG Fang()
JI Li-nong()
Journal Title:
CHINESE MEDICAL JOURNAL
Issue:
Volume 119, Issue 10, 2006
DOI:
Key Word:
diabetic retinopathy;type 2 diabetes;risk factors

Abstract: Background Advances in treatment have greatly reduced the risk of blindness from this disease, but because diabetes is so common, diabetic retinopathy remains an important problem. The purpose of this study is to investigate the risk factors of diabetic retinopathy (DR) in Chinese type 2 diabetic patients.Methods Totally 746 type 2 diabetic patients were selected for biochemical and clinical characteristics test and examined by the retina-camera for diabetic retinopathy and the average age was 55.9 years old.Results A total of 526 patients was classified as non-DR, 159 patients as non-proliferative-DR and 61 patients as proliferative-DR. Duration of diabetes [(66.09±72.51) months vs (143.71 ±93.27) months vs (174.30±81.91)months, P=0.00], systolic blood pressure [(131.95±47.20) mmHg vs (138.71 ±21.36) mmHg vs (147.58±24.10)mmHg, P=0.01], urine albumin [(32.79± 122.29) mg/L vs (190.96±455.65) mg/L vs (362.00±552.51) mg/L,P=0.00], glycated hemoglobin (HbA1c) [(8.68 ± 2.26)% vs (9.42±1.84)% vs (9.42±1.96)%, P=0.04],C-reactive protein (CRP) [(3.19±7.37) mg/L vs (6.36± 23.59) mg/L vs (3.02±4.34) mg/L, P=0.03],high-density lipoprotein cholesterol (HDL-C) [(1.23±0.37) mmol/L vs (1.33±0.35) mmol/L vs (1.24±0.33)mmol/L, P=0.01], uric acid (UA) [(288.51 ±90.85) mmol/L vs (300.29±101.98) mmol/L vs (337.57±115.09)mmol/L, P=0.00], creatinine (CREA) [(84.22±16.31) μmol/L vs (89.35±27.45) μmol/L vs (103.28±48.64)μmol/L, P=0.00], blood urine nitrogen (BUN) [(5.62± 1.62) mmol/L vs (6.55±2.74) mmol/L vs (8.11±3.60)mmol/L, P=0.00] were statistically different among the three groups. Logistic regression analysis showed that diabetic duration and urine albumin were two independent risk factors of DR (the OR values were 1.010 and 1.003 respectively).Conclusions Diabetic duration and urine albumin are two independent risk factors of diabetic retinopathy in elderly type 2 diabetic patients.

  • [1]Manaviat MR,Afkhami M,Shoja MR.Retinopathy and microalbuminuria in type Ⅱ diabetic patients.BMC Ophthalmol 2004; 4:9-12.
  • [2]Tapp R J,Shaw JE,Harper CA,de Courten MP,Balkau B,McCarty DJ,et al.The prevalence of and factors associated with diabetic retinopathy in the Australian population.Diabetes Care 2003; 26:1731-1737.
  • [3]van Leiden HA,Dekker JM,Moll AC,Nijpels G,Heine R J,Bouter LM,et al.Blood pressure,lipids,and obesity are associated with retinopathy.The Hoorn Study.Diabetes Care 2003; 25:1320-1325.
  • [4]Mitchell P,Moffitt P.Update and implications from the Newcastle diabetic retinopathy study.Aust N Z J Ophthalmol1990; 18:13-17.
  • [5]UK Prospective Diabetes Study Group.Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes.UKPDS33.Lancet 1998; 352:837-853.
  • [6]Herman WH,Aubert RE,Engelgau MM,Thompson T J,Ali MA,Sous ES,et al.Diabetes mellitus in Egypt:glycaemic control and microvascular and neuropathic complications.Diabet Med 1998; 15:1045-1051.
  • [7]McKay R,McCarty CA,Taylor HR.Diabetic retinopathy in Victoria,Australia:the Visual Impairment Project.Br J Ophthalmol 2000; 84:865-870.
  • [8]Klein R,Klein BE,Moss SE,Davis MD,DeMets DL.Glycosylated hemoglobin predicts the incidence and progression of diabetic retinopathy.JAMA 1988;260:2864-2871.
  • [9]Stratton IM,Kohner EM,Aldington S J,Turner RC,Holman RR,Manley SE,et al.UKPDS 50:Risk factors for incidence and progression of retinopathy in type 2diabetes over 6 years from diagnosis.Diabetologia 2001;44:156-163.
  • [10]Retinopathy and nephropathy in patients with type 1diabetes four years after a trial of intensive therapy.The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research Group.N Engl J Med 2000; 342:381-389.
  • [11]Robert N.Frank.Diabetic retinopathy.N Engl J Med 2004; 350:48-58.
  • [12]Lunctta M,Infantonc L,Calogero AE,Infantone E.Increased urinary albumin excretion is a marker of risk for retinopathy and coronary heart disease in patients with type 2 diabetes mellitus.Diabetes Res Clin Pract 1998; 40:45-51.
  • [13]Klein BE,Moss SE,Klein R,Surawicz TS.The Wisconsin Epidemiological study of Diabetic Retinopathy.ⅩⅢ.Relationship of serum cholesterol to retinopathy and hard exudates.Ophthalmology 1991; 98:1261-1265.
  • [14]Miljanovic B,Glynn R J,Nathan DM,Manson JE,Schaumberg DA.A prospective study of serum lipids and risk of diabetic macular edema in type 1 diabetes.Diabetes 2004; 53:2883-2892.
  • [15]Chew EY,Klein ML,Ferris FL,Remaley NA,Murphy RP,Chantry K,et al.Association of elevated serum lipid levels with retinal hard exudates in diabetic retinopathy.Early Treatment Diabetic Retinopathy Study (ETDRS)Report 22.Arch Ophthalmol1996; 114:1079-1084.
  • [16]Matthews DR,Stratton IM,Aldington S J,Holman RR,Kohner EM; UK Prospective Diabetes Study Group.Risks of progression of retinopathy and vision loss related to tight blood pressure control in type 2 diabetes mellitus:UKPDS 69.Arch Ophthalmol 2004; 122:1631-1640.
WanfangData CO.,Ltd All Rights Reserved
About WanfangData | Contact US
Healthcare Department, Fuxing Road NO.15, Haidian District Beijing, 100038 P.R.China
Tel:+86-010-58882616 Fax:+86-010-58882615 Email:yiyao@wanfangdata.com.cn