摘要
目的探讨1型糖尿病(T1DM)患者糖尿病视网膜病变(DR)的影响因素。方法采用横断面研究, 纳入2016年1月至2023年5月在天津医科大学朱宪彝纪念医院住院的T1DM患者。收集患者的一般临床资料及实验室检查指标, 根据眼底检查结果将患者分为DR组及无DR组。采用logistic回归分析T1DM患者发生DR的影响因素。结果共纳入1 086例T1DM患者, DR的检出率为34.3%(372/1 086)。与无DR组相比, T1DM伴DR组患者病程更长, 体重指数(BMI)、血压、血尿素氮、甘油三酯、总胆固醇更高, 且合并糖尿病肾脏病、糖尿病周围神经病变的比例更高, 而白蛋白、间接胆红素、直接胆红素、估算的肾小球滤过率(eGFR)、血红蛋白水平更低, 差异均有统计学意义(P均<0.05)。多因素logistic回归分析显示, 糖尿病病程(OR=1.12, 95%CI:1.09~1.15)、糖尿病肾脏病(OR=4.96, 95%CI: 2.96~8.31)、糖尿病周围神经病变(OR=1.59, 95%CI:1.12~2.24)和血尿素氮(OR=1.14, 95%CI:1.02~1.26)为DR的独立危险因素, 直接胆红素(OR=0.90, 95%CI:0.81~0.99)与DR发生风险呈负相关。结论糖尿病病程、糖尿病肾脏病、糖尿病周围神经病变及血尿素氮与T1DM患者DR风险增加显著相关, 直接胆红素则与DR呈负相关。
Objective To explore the influencing factors of diabetic retinopathy(DR)in patients with type 1 diabetes mellitus(TIDM).Methods This study was a cross-sectional study.TIDM patients who were hospitalized in Chu Hsien-I Memorial Hospital from January 2016 to May 2023 were included.General clinical data and laboratory indicators of the patients were collected,and the patients were divided into a DR group and a non-DR group according to non-mydriatic fundus photography.Logistic regression was utilized to analyze the influencing factors for DR in patients with TIDM.Results A total of 1086 patients with T1DM were included,and the detection rate of DR was 34.3%(372/1086).Compared to the non-DR group,patients in the TIDM with DR group had a longer duration of diabetes,higher body mass index(BMI),blood pressure,blood urea nitrogen,triglycerides,total cholesterol,as well as a higher proportion of diabetic kidney disease and diabetic peripheral neuropathy.Conversely,levels of albumin,indirect bilirubin,direct bilirubin,estimated glomerular fltration rate(eGFR),and hemoglobin were lower in this group,with all differences being statistically significant(all P<0.05).Multivariate logistic regression analysis showed that duration of diabetes(OR=1.12,95%CI:1.09-1.15),diabetic kidney disease(OR=4.96,95%CI:2.96-8.31),diabetic peripheral neuropathy(OR=1.59,95%CI:1.12-2.24),and blood urea nitrogen(OR=1.14,95%CI:1.02-1.26)were independent risk factors for DR,while direct bilirubin(OR=0.90,95%CI:0.81-0.99)was negatively correlated with the risk of DR.Conclusion Duration of diabetes,diabetes kidney disease,diabetic peripheral neuropathy,and blood urea nitrogen are significantly associated with an increased risk of DR in patients with TIDM,and direct bilirubin is negatively correlated with DR.
作者
李颖颖
孙丹丹
包頔
穆纯
邢秋玲
Li Yingying;Sun Dandan;Bao Di;Mu Chun;Xing Qiuling(National Health Commission Key Laboratory of Hormones and Development,Tianjin Key Laboratory of Metabolic Diseases,Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology,Tianjin Medical University,Tianjin 300134,China;Department of Infection,National Health Commission Key Laboratory of Hormones and Development,Tianjin Key Laboratory of Metabolic Diseases,Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology,Tianjin Medical University,Tianjin 300134,China;Department of Ophthalmology,National Health Commission Key Laboratory of Hormones and Development,Tianjin Key Laboratory of Metabolic Diseases,Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology,Tianjin Medical University,Tianjin 300134,China;Department of Medical Record,National Health Commission Key Laboratory of Hormones and Development,Tianjin Key Laboratory of Metabolic Diseases,Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology,Tianjin Medical University,Tianjin 300134,China)
出处
《国际内分泌代谢杂志》
2025年第4期237-243,共7页
International Journal of Endocrinology and Metabolism
基金
天津医科大学学科科研专项项目(2024XKHL04)。
