Risk factors for progression of early diabetic retinopathy
Objective To explore the risk factors for occurrence and progression of early diabetic retinopathy(DR)in patients with type 2 diabetes mellitus(T2DM).Method A total of 344 T2DM patients with or without early diabetic retinopathy(DR)who were fol-lowed for a long period of time were included.The clinical information and biochemical indicators were collected retrospectively to ana-lyze risk factors for early presence of DR.The level of DR was categorized according to ETDRS diabetic retinopathy severity scale(DRSS).Based on the severity scale of DR recorded on the follow-up information,a binary logistic regression method was used to se-lect the risk factors for earlier progression of DR.A further exploration was performed to find the related factors for aggravation of high levels of DR in patients with progression and ROC curve was used to predict the value of selected factors.Results Duration of diabetes,insult treatment and postprandial 2hC peptide were independent risk factors for presence of early DR.The DR patients with a higher level of apolipoprotein a(AOPA)and indirect bilirubin(IBIL)were more likely to have DR progression within two years.For patients with progression,high density lipoprotein(HDL)was proved to be risk factor for aggravation more than 2 levels.The results of ROC curve showed that the area under the curve(AUC)of HDL predicting the rapid aggravation of early DR was 0.621 and the best cut-off value was 1.585 mmol/L.Conclusion Follow-up should be strengthened for patients with longer duration of diabetes who are at a grea-ter risk of developing DR and patients with insulin therapy and low postprandial 2hC peptide levels which may indicate poor islet func-tion and poor glycemic control.APOA,IBIL and HDL were associated with the early and rapid aggravation of DR.The occurrence of vision-threatening complications might be reduced by controlling these related factors promptly.
Type 2 diabetes mellitusEarly diabetic retinopathyRisk factors
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