1
|
Syriga M, Ioannou Z, Pitsas C, Dagalaki I, Karampelas M. Diabetic retinopathy in Greece: prevalence and risk factors studied in the medical retina clinic of a Greek tertiary hospital. Int Ophthalmol 2022; 42:1679-1687. [DOI: 10.1007/s10792-021-02162-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 12/18/2021] [Indexed: 12/01/2022]
|
2
|
Li Y, Li C, Zhao S, Yin Y, Zhang X, Wang K. Nomogram for Prediction of Diabetic Retinopathy Among Type 2 Diabetes Population in Xinjiang, China. Diabetes Metab Syndr Obes 2022; 15:1077-1089. [PMID: 35418766 PMCID: PMC8999722 DOI: 10.2147/dmso.s354611] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/23/2022] [Indexed: 01/21/2023] Open
Abstract
PURPOSE To establish an accurate risk prediction model of diabetic retinopathy (DR) using cost effective and easily available patients' characteristics and clinical biomarkers. PATIENTS AND METHODS Totally 18,904 cases diagnosed type 2 diabetes mellitus (T2DM) were collected, among which 13,980 cases were selected after quality screening. The least absolute shrinkage and selection operator (LASSO) regression models were used for univariate analysis and factors selection, and the multi-factor logistic regression analysis was used to establish the prediction model. Discrimination, calibration, and clinical usefulness of the prediction model were assessed using AUC/ Harrell's C statistic, calibration plot, and decision curve analysis. Both the development group and validation group were assessed. RESULTS Candidate variables were selected by Lasso regression and multivariate logistic regression analysis. Finally, the candidate predictive variables were included diabetic peripheral neuropathy (DPN), age, neutrophilic granulocyte (NE), high-density lipoprotein (HDL), hemoglobin A1c (HbA1C), duration of T2DM, and glycosylated serum protein (GSP) were used to establish a nomogram model for predicting the risk of DR. In the development group, the area under the receiver operating characteristic curve (AUC) was 0.882 (95% CI, 0.875-0.888). In the validation group, the AUC was 0.870 (95% CI, 0.856-0.881). Meanwhile, the optimism-corrected Harrell's C statistic were 0.878 and 0.867 in the development group and the validation group, respectively. Decision curve analysis demonstrated that the nomogram was clinically useful. CONCLUSION We constructed and verified nomograms that could accurately predict the risk of DR in T2DM patients, which could be used to predict the personalized risk of DR patients in Xinjiang, China.
Collapse
Affiliation(s)
- Yongsheng Li
- College of Public Health, Xinjiang Medical University, Urumqi, 830011, People’s Republic of China
| | - Cheng Li
- Center for Data Statistics and Analysis, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, People’s Republic of China
| | - Shi Zhao
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, 999077, People’s Republic of China
| | - Yi Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, 211166, People’s Republic of China
| | - Xueliang Zhang
- Department of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, 830011, People’s Republic of China
- Correspondence: Xueliang Zhang; Kai Wang, Department of Medical Engineering and Technology, Xinjiang Medical University, No. 567 Shangde North Road, Shuimogou District, Urumqi City, Xinjiang, 830011, People’s Republic of China, Tel +86 18999978069; +86 13999801720, Fax +8609912110396, Email ;
| | - Kai Wang
- Department of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, 830011, People’s Republic of China
| |
Collapse
|
3
|
Hashemi H, Rezvan F, Pakzad R, Ansaripour A, Heydarian S, Yekta A, Ostadimoghaddam H, Pakbin M, Khabazkhoob M. Global and Regional Prevalence of Diabetic Retinopathy; A Comprehensive Systematic Review and Meta-analysis. Semin Ophthalmol 2021; 37:291-306. [PMID: 34402390 DOI: 10.1080/08820538.2021.1962920] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE We conducted a systematic search to estimate DR prevalence in different age and gender groups, and to evaluate the determinants of heterogeneity in its prevalence. METHODS A systematic and comprehensive search from inception to August 10, 2020, was done in international databases, including Scopus, PubMed, Web of Science, Embase, and other data sources without any restriction to find cross-sectional studies related to the prevalence of DR. RESULTS Of 6399 studies, 90 articles with a sample size of 563460 individuals and 204189 diabetic patients were analyzed. The estimated pooled prevalence of DR in the diabetic population in general; in female and in male was 28.41% (95% CI: 25.98 to 30.84); 25.93% (95% CI: 23.54 to 28.31) and 28.95% (95% CI: 26.57 to 31.32); respectively and the prevalence of DR showed no inter-gender difference. The heterogeneity of the pooled prevalence according to I2 was 99% (p < .001). According to the meta-regression results, the variables of WHO region (Coefficient of AMRO vs SEARO: 15.56; p: 0.002), age (Coefficient of above 60 years vs below 40 year: 18.67; p: 0.001), type of DR (Coefficient: 19.01; p < .001), and publication year (Coefficient: -0.60; p: 0.001) had a significant correlation with heterogeneity. CONCLUSION One third of diabetic patients suffered from DR, mostly NPDR. DR increased markedly after the age of 60 years, which could be due to the longer duration of diabetes. Age, WHO region, type of DR, and publication year affected the heterogeneity in the prevalence of DR.
Collapse
Affiliation(s)
- Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Farhad Rezvan
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
| | - Reza Pakzad
- Department of Epidemiology, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran
| | | | | | - Abbasali Yekta
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Rehabilitation Science, School of Allied Medical Sciences, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hadi Ostadimoghaddam
- Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mojgan Pakbin
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Mehdi Khabazkhoob
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
4
|
Liu DW, Haq Z, Yang D, Stewart JM. Association between smoking history and optical coherence tomography angiography findings in diabetic patients without diabetic retinopathy. PLoS One 2021; 16:e0253928. [PMID: 34242286 PMCID: PMC8270137 DOI: 10.1371/journal.pone.0253928] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 06/15/2021] [Indexed: 12/23/2022] Open
Abstract
Purpose To investigate any associations between cigarette smoking and retinal microvascular changes in diabetic patients without visible retinopathy. Design Retrospective, cross-sectional study. Participants 1099 eyes from 1099 diabetic patients with no clinical evidence of diabetic retinopathy (DR) were included in this study. Methods Diabetic patients underwent optical coherence tomography angiography (OCTA) scanning at Zuckerberg San Francisco General Hospital and Trauma Center between April 2018 and September 2019. Patient demographic and clinical information was collected. Standard bivariate statistics and multivariate linear regression were performed. Main outcome measures OCTA parameters included metrics related to the foveal avascular zone (FAZ; area, perimeter, circularity), perfusion density (PD; full, center, inner), and vessel length density (VLD; full, center, inner). Results The study population included 750 non-smokers and 349 smokers. FAZ perimeter was the only OCTA parameter that was significantly different between the two groups on uncontrolled analysis (P = 0.033). Multivariate regression analyses revealed significant associations between lower VLD full (β = -0.31, P = 0.048), lower VLD inner (β = -0.35, P = 0.046) and a history of smoking. No significant associations between cigarette smoking and either FAZ or PD were detected. Conclusions Our results suggest that smoking is likely associated with deleterious changes in the retinal microvasculature of patients with a history of diabetes and no visible DR. Based on these findings, diabetic patients with a history of smoking may benefit from higher prioritization in terms of ophthalmic screening.
Collapse
Affiliation(s)
- Dong-Wei Liu
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California, United States of America
- Department of Ophthalmology, Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, California, United States of America
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Zeeshan Haq
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California, United States of America
- Department of Ophthalmology, Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, California, United States of America
| | - Daphne Yang
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California, United States of America
- Department of Ophthalmology, Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, California, United States of America
| | - Jay M. Stewart
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California, United States of America
- Department of Ophthalmology, Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, California, United States of America
- * E-mail:
| |
Collapse
|
5
|
Shi R, Niu Z, Wu B, Hu F. Study on the Risk Factors for Hyperuricaemia and Related Vascular Complications in Patients with Type 2 Diabetes Mellitus. Risk Manag Healthc Policy 2020; 13:1661-1675. [PMID: 33061700 PMCID: PMC7518772 DOI: 10.2147/rmhp.s255042] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 08/17/2020] [Indexed: 12/28/2022] Open
Abstract
Purpose The study aimed to identify diseases that exhibit significant differences between hyperuricaemia (HUA) and non-hyperuricaemia (NHUA) groups and analyse the risk factors for HUA based on the related diseases in type 2 diabetes mellitus (T2DM). Methods A total of 3264 T2DM patients were investigated from 2013 to 2017 in the Jinyang and Sanlin communities by obtaining basic data from the electronic medical record system (EMRS). From September 2018 to July 2019, 3000 patients (264 patients were missing during follow-up) were investigated with questionnaires, physical examinations and biochemical index tests. After removing missing values, 2899 patients were divided into HUA and NHUA groups. The chi-square test was used to identify diseases with differences. Using Lasso analysis and logistic regression analysis, risk factors for HUA based on the related diseases were obtained. The C-index, receiver operating characteristic (ROC) curve and calibration plot were used to validate the discrimination and accuracy of the factors. Results The chi-square test showed that there were significant differences in coronary heart disease (CHD) and diabetic nephropathy (DN) between the HUA group and the NHUA group. Through Lasso regression, glycosylated haemoglobin A1c (HbA1c), triglyceride (TG), blood urea nitrogen (BUN) and serum creatinine (SCR) were screened in the CHD group. Body mass index (BMI), HbA1c, total cholesterol (TC), TG, BUN, SCR and urine microalbumin (UMA) were screened in the DN group. The P-value of all the variables was less than 0.05. Through the C-index, calibration, and ROC curve analyses, these risk factors had medium accuracy. Conclusion HUA was significantly related to CHD and DN. The level of UA was correlated with HbA1c, TG, BUN, and SCR based on CHD. The level of UA was associated with BMI, HbA1c, TC, TG, BUN, SCR, and UMA based on DN.
Collapse
Affiliation(s)
- Rong Shi
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Zheyun Niu
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Birong Wu
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Fan Hu
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
| |
Collapse
|
6
|
Shi R, Niu Z, Wu B, Zhang T, Cai D, Sun H, Hu Y, Mo R, Hu F. Nomogram for the Risk of Diabetic Nephropathy or Diabetic Retinopathy Among Patients with Type 2 Diabetes Mellitus Based on Questionnaire and Biochemical Indicators: A Cross-Sectional Study. Diabetes Metab Syndr Obes 2020; 13:1215-1229. [PMID: 32368114 PMCID: PMC7182465 DOI: 10.2147/dmso.s244061] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 04/08/2020] [Indexed: 12/13/2022] Open
Abstract
PURPOSE This study aimed to develop a diabetic nephropathy (DN) or diabetic retinopathy (DR) incidence risk nomogram in China's population with type 2 diabetes mellitus (T2DM) based on a community-based sample. METHODS We carried out questionnaire evaluations, physical examinations and biochemical tests among 4219 T2DM patients in Shanghai. According to the incidence of DN and DR, 4219 patients in our study were divided into groups of T2DM patients with DN or DR, patients with both, and patients without any complications. We successively used least absolute shrinkage and selection operator regression analysis and logistic regression analysis to optimize the feature selection for DN and DR. To ensure the accuracy of the results, we carried out multivariable logistic regression analysis of the above significant risk factors on the sample data for both DN and DR. The selected features were included to establish a prediction model. The C-index, calibration plot, curve analysis and internal validation were used to validate the distinction, calibration, and clinical practicality of the model. RESULTS The predictors in the prediction model included disease course, body mass index (BMI), total triglycerides (TGs), systolic blood pressure (SBP), postprandial blood glucose (PBG), haemoglobin A1C (HbA1c) and blood urea nitrogen (BUN). The model displayed moderate predictive power with a C-index of 0.807 and an area under the receiver operating characteristic curve of 0.807. In internal verification, the C-index reached 0.804. The risk threshold was 16-75% according to the analysis of the decision curve, and the nomogram could be applied in clinical practice. CONCLUSION This DN or DR incidence risk nomogram incorporating disease course, BMI, TGs, SBP, PBG, HbA1c and BUN can be used to predict DN or DR incidence risk in T2DM patients. The research team has developed an online app based on a clinical prediction model incorporating risk factors for rapid and simple prediction.
Collapse
Affiliation(s)
- Rong Shi
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Zheyun Niu
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Birong Wu
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Taotao Zhang
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Dujie Cai
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Hui Sun
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Yuhong Hu
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Ruohui Mo
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Fan Hu
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
- Correspondence: Fan Hu School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of ChinaTel +8613585828140Fax +862151322466 Email
| |
Collapse
|
7
|
Zhong ZL, Chen S. Indicating and predicting role of the horizontal C/D ratio in preclinical diabetic retinopathy associated with chronic angle-closure glaucoma. Int J Ophthalmol 2019; 12:268-274. [PMID: 30809483 DOI: 10.18240/ijo.2019.02.13] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 11/19/2018] [Indexed: 01/11/2023] Open
Abstract
AIM To observe morphological optic disc characteristics in patients with preclinical diabetic retinopathy (DR) associated with chronic angle-closure glaucoma (CACG). METHODS Twenty-two cases (43 eyes) of preclinical DR associated with CACG were enrolled in group A; 24 preclinical DR cases (46 eyes) were enrolled in group B; 26 CACG cases (51 eyes) were enrolled in group C; and 49 normal controls (49 eyes) were enrolled in group D. All underwent optical coherence tomography to measure the horizontal C/D ratio (HCDR), C/D area ratio (CDaR), vertical C/D ratio (VCDR), rim area (RA), cup volume (CV), disc area (DA) and average retinal nerve fiber layer (RNFL) thickness. RESULTS The ages of groups A, B, C, and D were 67.60±3.36, 66.78±3.33, 65.98±3.83, and 67.54±3.17y, respectively. The HCDR values in groups A, B, and C were distinct relative to those in group D (P<0.0001, P<0.01, and P<0.05, respectively). The HCDR values in group A were higher compared with those in groups B (P<0.0001) and D (P<0.0001); while these values were virtually identical statistically between groups A and C (P>0.05). The CDaR values in group A were higher in comparison to those in groups B and D (P<0.0001 in both groups); while these values were virtually identical statistically between groups A and C (P>0.05). The RA values in group A were smaller relative to those in groups B and D (P<0.0001 in both groups); while groups A and C were not distinct statistically (P>0.05). The CV values in group A were greater in comparison to those in groups B and D (P<0.0001 in both groups); while groups A and C were not distinct statistically (P>0.05). DA was not distinct for comparisons of two groups among the four groups (P>0.05). HCDR value correlated with mean nasal RNFL thickness (r=-0.909, P<0.0001), mean superior RNFL thickness (r=-0.866, P<0.0001), mean inferior RNFL thickness (r=-0.650, P<0.001) and mean temporal RNFL thickness (r=-0.562, P<0.01) in group A. CONCLUSION The HCDR was a sensitive morphological parameter in detecting structural visual disc changes in preclinical DR associated with CACG, which can reflect optic nerve damage caused jointly by CACG and diabetes. A higher HCDR may predict optic nerve atrophy.
Collapse
Affiliation(s)
- Ze-Long Zhong
- Department of Vitreoretinopathy, Tianjin Eye Hospital, Tianjin 300020, China.,Nankai Univesity Affilliated Eye Hospital, Tianjin 300020, China.,Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300020, China
| | - Song Chen
- Department of Vitreoretinopathy, Tianjin Eye Hospital, Tianjin 300020, China.,Nankai Univesity Affilliated Eye Hospital, Tianjin 300020, China.,Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300020, China
| |
Collapse
|
8
|
Campagna D, Alamo A, Di Pino A, Russo C, Calogero AE, Purrello F, Polosa R. Smoking and diabetes: dangerous liaisons and confusing relationships. Diabetol Metab Syndr 2019; 11:85. [PMID: 31666811 PMCID: PMC6813988 DOI: 10.1186/s13098-019-0482-2] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 10/11/2019] [Indexed: 02/07/2023] Open
Abstract
The combined harmful effects of cigarette smoking and hyperglycemia can accelerate vascular damage in patients with diabetes who smoke, as is well known. Can smoking cause diabetes? What are the effects of smoking on macro and microvascular complications? Now growing evidence indicates that regular smokers are at risk of developing incident diabetes. Since the prevalence rates of smoking in patients with diabetes are relatively similar to those of the general population, it is essential to address the main modifiable risk factor of smoking to prevent the onset of diabetes and delay the development of its complications. Quitting smoking shows clear benefits in terms of reducing or slowing the risk of cardiovascular morbidity and mortality in people with diabetes. Does quitting smoking decrease the incidence of diabetes and its progression? What are the effects of quitting smoking on complications? The current evidence does not seem to unequivocally suggest a positive role for quitting in patients with diabetes. Quitting smoking has also been shown to have a negative impact on body weight, glycemic control and subsequent increased risk of new-onset diabetes. Moreover, its role on microvascular complications of the disease is unclear. What are the current smoking cessation treatments, and which ones are better for patients with diabetes? Stopping smoking may be of value for diabetes prevention and management of the disease and its macrovascular and microvascular complications. Unfortunately, achieving long-lasting abstinence is not easy and novel approaches for managing these patients are needed. This narrative review examines the evidence on the impact of smoking and smoking cessation in patients with diabetes and particularly in type 2 diabetes mellitus and its complications. In addition, management options and potential future directions will be discussed.
Collapse
Affiliation(s)
- D. Campagna
- Centro per la Prevenzione e Cura del Tabagismo (CPCT), University Teaching Hospital “Policlinico-Vittorio Emanuele”, University of Catania, Catania, Italy
- U.O.C. MCAU, University Teaching Hospital “Policlinico-Vittorio Emanuele”, University of Catania, Catania, Italy
| | - A. Alamo
- Centro per la Prevenzione e Cura del Tabagismo (CPCT), University Teaching Hospital “Policlinico-Vittorio Emanuele”, University of Catania, Catania, Italy
- Division of Andrology and Endocrinology, University Teaching Hospital “Policlinico-Vittorio Emanuele”, University of Catania, Catania, Italy
- Department of Clinical and Experimental Medicine, (MEDCLIN), University of Catania, Catania, Italy
| | - A. Di Pino
- Department of Clinical and Experimental Medicine, (MEDCLIN), University of Catania, Catania, Italy
- Center of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, Catania, Italy
| | - C. Russo
- Centro per la Prevenzione e Cura del Tabagismo (CPCT), University Teaching Hospital “Policlinico-Vittorio Emanuele”, University of Catania, Catania, Italy
| | - A. E. Calogero
- Division of Andrology and Endocrinology, University Teaching Hospital “Policlinico-Vittorio Emanuele”, University of Catania, Catania, Italy
- Department of Clinical and Experimental Medicine, (MEDCLIN), University of Catania, Catania, Italy
- Center of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, Catania, Italy
| | - F. Purrello
- Department of Clinical and Experimental Medicine, (MEDCLIN), University of Catania, Catania, Italy
- Center of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, Catania, Italy
| | - R. Polosa
- Centro per la Prevenzione e Cura del Tabagismo (CPCT), University Teaching Hospital “Policlinico-Vittorio Emanuele”, University of Catania, Catania, Italy
- Department of Clinical and Experimental Medicine, (MEDCLIN), University of Catania, Catania, Italy
- Center of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, Catania, Italy
| |
Collapse
|
9
|
Jiang J, Liu Y, Chen Y, Ma B, Qian Y, Zhang Z, Zhu D, Wang Z, Xu X. Analysis of Changes in Retinal Thickness in Type 2 Diabetes without Diabetic Retinopathy. J Diabetes Res 2018; 2018:3082893. [PMID: 29682578 PMCID: PMC5845508 DOI: 10.1155/2018/3082893] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 09/22/2017] [Accepted: 10/30/2017] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE To examine the changes in retinal thickness of patients with diabetes without DR. DESIGNS A randomization, crossover, retrospective practice. PARTICIPANTS 43 diabetic patients and 43 ethnic-, age-, and sex-matched controls. METHODS Full retinal thicknesses of ten areas were assessed using spectral domain optical coherence tomography. Confounding variables, such as age, gender, and glycated haemoglobin (HbA1c) level, were assessed by regression analysis. MAIN OUTCOME MEASURES Mean retinal thickness of ten areas. RESULTS The mean thickness of the fovea was 215.8 ± 18.9 μm in the diabetes group and 222.0 ± 18.6 μm in the control group (p = 0.04). The mean thickness of the temporal parafovea was 319.9 ± 16.7 μm in the diabetes group and 326.0 ± 14.4 μm in the control group (p = 0.01). The mean thickness of the temporal perifovea was 276.4 ± 27.9 μm in the diabetes group and 284.8 ± 17.4 μm in the control group (p = 0.02). There were no significant differences in retinal thickness between groups in other areas (p > 0.05). Regression analysis revealed that decreased retinal thickness of the temporal perifovea was associated with a higher HbA1c level (>8.7%) (p = 0.04). CONCLUSION AND RELEVANCE Subtle structural changes in the retina may occur in diabetes without DR. Decreased retinal thickness appeared to begin in the fovea and temporal areas. A high HbA1c level was the main factor influencing retinal thickness.
Collapse
Affiliation(s)
- Jing Jiang
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
- Department of Ophthalmology, Huashan Hospital of Fudan University, Shanghai, China
| | - Yan Liu
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Yingchao Chen
- Department of Endocrinology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Bo Ma
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Yiwen Qian
- Department of Ophthalmology, Huashan Hospital of Fudan University, Shanghai, China
| | - Zhenzhen Zhang
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Dongqing Zhu
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Zhiliang Wang
- Department of Ophthalmology, Huashan Hospital of Fudan University, Shanghai, China
| | - Xiaofang Xu
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| |
Collapse
|
10
|
Liu Y, Yang J, Tao L, Lv H, Jiang X, Zhang M, Li X. Risk factors of diabetic retinopathy and sight-threatening diabetic retinopathy: a cross-sectional study of 13 473 patients with type 2 diabetes mellitus in mainland China. BMJ Open 2017; 7:e016280. [PMID: 28864696 PMCID: PMC5588996 DOI: 10.1136/bmjopen-2017-016280] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 08/01/2017] [Accepted: 08/09/2017] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To explore the risk factors of diabetic retinopathy (DR) and sight-threatening diabetic retinopathy (STDR) among Chinese patients with diabetes. DESIGN, SETTING AND PARTICIPANTS A cross-sectional investigation was performed in eight screening clinics in six provinces across mainland China. Information about the risk factors was recorded in screening clinics. Some risk factors (sex, age, diagnosis age, diabetes duration, systolic blood pressure (SBP), diastolic blood pressure, fasting blood glucose (FBG) and glycosylated haemoglobin (HbA1c)) were recorded in all eight clinics, while others were collected only in a subset of the clinics. The relationships between the risk factors and DR and between the risk factors and STDR were explored for the eight factors mentioned above and for all factors studied. MAIN OUTCOMES AND MEASURES Risk factors of DR and STDR were assessed, and a nomogram of the results was produced. RESULTS Younger age, longer diabetes duration, higher SBP, higher FBG and higher HbA1c were found to be independent risk factors for both DR and STDR in the eight-factor analyses. In the all-factor analysis, younger age, longer diabetes duration, higher SBP, oral medicine use and insulin use were independent risk factors for both DR and STDR; higher postprandial blood glucose (PBG), HbA1c, triglyceride andlow-density lipoprotein were independent risk factors for DR only, and higher FBG was a risk factor for STDR only. CONCLUSIONS In this cross-sectional investigation, several risk factors were found for DR and STDR. Notably, FBG, PBG and HbA1c were all risk factors for DR or STDR, suggesting that stricter blood glucose control in clinical practice is required.
Collapse
Affiliation(s)
- Yan Liu
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Jiarui Yang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Liyuan Tao
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Huibin Lv
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Xiaodan Jiang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Mingzhou Zhang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Xuemin Li
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| |
Collapse
|