摘要
目的 调查洛阳市五股路社区65岁及以上居民糖尿病视网膜病变(DR)的患病率及其相关危险因素.方法 横断面研究.选择2023年4至8月在五股路社区服务中心参与2023年度洛阳市65岁及以上居民健康体检的该社区人群为研究对象.所有受检者进行体格检查和相关实验室指标检测.对确诊为糖尿病的人群,以问卷调查的方式进一步收集其一般情况、社会经济情况、生活方式、既往病史、家族史等信息,并完善眼科相关检查.计算糖尿病、DR、糖尿病黄斑水肿(DME)的患病率,比较糖尿病患者中非DR组与DR组的临床资料,分析组间差异及发生DR的独立危险因素.结果 本研究共纳入581例,其中糖尿病患者为138例,均患2型糖尿病,患病率为23.75％(138/581).糖尿病患者中因屈光间质混浊导致视网膜窥不清者6例被剔除,最终纳入DR流行病学研究的糖尿病患者132例,筛查出DR患者32例,DR患病率为24.24％(32/132);其中DR分级例数及患病率分别为轻度非增生型 DR(NPDR)19 例(14.39％)、中度 NPDR 10 例(7.58％)、重度 NPDR 2 例(1.51％)、增生型 DR(PDR)1例(0.76％);筛查出患有DME者3例,患病率为2.27％(3/132).尿蛋白、糖尿病病程、平素空腹血糖控制水平、糖尿病发病年龄以及药物降糖治疗疗程等因素,在糖尿病患者中非DR组和DR组两组间比较差异具有统计学意义(x2=5.16,P=0.023;Z=-3.41,P=0.001;x2=11.79,P=0.003;Z=-2.99,P=0.003;Z=-2.53,P=0.011).经二元 logistic 回归分析发现,糖尿病病程(OR=1.27,95％CI:1.041～1.542,P=0.018)、平素空腹血糖控制水平(OR=2.22,95％CI:1.078～4.589,P=0.031)是发生 DR 的独立危险因素.结论 洛阳市五股路社区65岁及以上居民糖尿病患病率为23.75％,DR患病率为24.24％,DME患病率为2.27％;糖尿病病程越长,平素空腹血糖水平越高者,发生DR的风险越大.
Abstract
Objective To investigate the prevalence of diabetic retinopathy(DR)in residents aged 65 years and above in Wugulu community of Luoyang City,and to investigate the related risk factors of DR.Methods This was a cross-sectional study.The population aged 65 years and above in this community in Luoyang City who participated in the 2023 health examination of residents from Apr.2023 to Aug.2023 at the Wugulu Community Service Center were included in the study.All subjects underwent physical examination and relevant laboratory indicators testing.From the people diagnosed as diabetes mellitus,the information of general condition,social economic condition,life style,past medical history and family history were collected by questionnaire,and missing ophthalmology related examinations were appended.The prevalence rates of diabetes mellitus,DR and diabetic macular edema(DME)were calculated,and the clinical data were compared between the non-DR group and the DR group in diabetic patients.The differences between groups and independent risk factors of developing DR were analyzed.Results There were 581 patients who participated in the survey,and 138 patients had type 2 diabetes mellitus,with a prevalence rate at 23.75％(138/581).Among the diabetic patients,6 cases of retinal blur caused by refractive interstitial opacity were excluded,and 132 diabetic patients were finally included in the DR epidemiological study,and 32 patients had DR,with a prevalence rate of DR at 24.24％(32/132).Among the DR patients,the number and prevalence of mild non proliferative(NPDR),moderate NPDR,severe NPDR and proliferative(PDR)were 19 cases(14.39％),10 cases(7.58％),2 cases(1.51％)and 1 case(0.76％),respectively.The number and prevalence of DME was 3 cases(2.27％,3/132).There were statistically significant differences between the non-DR and DR groups of diabetic patients in urinary protein,course of diabetes mellitus,level of fasting blood glucose control,diabetes onset age and course of drug hypoglycemic treatment(x2=5.16,P=0.023;Z=-3.41,P=0.001;x2=11.79,P=0.003;Z=-2.99,P=0.003;Z=-2.53,P=0.011).Binary logistic regression analysis identified that course of diabetes mellitus(OR=1.27,95％CI:1.041-1.542,P=0.018),level of fasting blood glucose control(OR=2.22,95％CI:1.078-4.589,P=0.031)were independent risk factors of DR.Conclusion Among the residents aged 65 years and above in Wugulu community of Luoyang City,the prevalence of diabetes mellitus,DR and DME are 23.75％,24.24％and 2.27％,respectively.The longer the course of diabetes mellitus and the higher the fasting blood glucose level,the greater the risk of DR.
NETL
NSTL
万方数据