糖化血红蛋白与糖尿病视网膜病变的关系:北京社区糖尿病研究18
发布时间：2018-10-22 12:33
【摘要】：目的探讨糖化血红蛋白(HbA1c)与糖尿病视网膜病变(DR)的关系及其诊断阈值。设计以社区人群为基础的横断面研究。研究对象北京社区糖尿病研究中2642例20~80岁已确诊的2型糖尿病患者,其中2007例(76.0%)受试者(1199例女性)参与研究,平均年龄(64.1±9.0)岁。方法全体参与医师经过专门培训,按照统一要求调查并填写调查表,同时对患者进行体格检查及相关的实验室检查,HbA1c用美国伯乐公司高压液相仪测定,并对所有患者用45°免散瞳彩色眼底照相机留取后极部眼底照片一张。DR的严重程度参照Airlie House分级法。采用ROC曲线分析HbA1c诊断DR的最佳阈值。主要指标HbA1c在DR中的诊断阈值(敏感性、特异性、AUC)。结果本人群中DR患病率为(24.7±1.0)%(95%CI,22.8~26.6)。在二元逻辑回归分析中,DR的出现与较高的HbA1c浓度(OR=1.23;95%CI,1.14~1.33)有关,随着HbA1c增高,DR患病率呈上升趋势。当HbA1c≥6.5%时,诊断DR的ROC曲线下面积最大(59.2%),且敏感性(75.1%)和特异性(43.4%)高。在二元逻辑回归分析中,DR还与其他方面有关:较轻的年龄(OR=0.97;95%CI,0.95~0.98)、较长的糖尿病病程(OR=1.10;95%CI,1.08~1.12)、较高的收缩压(OR=1.01;95%CI,1.01~1.02)、较低的体重指数(OR=0.95;95%CI,0.92~0.98)和升高的血尿素氮浓度(OR=1.01;95%CI,1.00~1.01)。结论当糖化血红蛋白≥6.5%时与糖尿病视网膜病变显著相关,提示糖化血红蛋白为6.5%或许可以作为筛查糖尿病视网膜病变的阈值。
[Abstract]:Objective to investigate the relationship between glycosylated hemoglobin (HbA1c) and diabetic retinopathy (DR) and its diagnostic threshold. Design a cross-sectional study based on community population. Participants 2642 patients with type 2 diabetes between 20 and 80 years of age were enrolled in the Beijing community diabetes study. 2007 (76.0%) subjects (1199 women) participated in the study, with an average age of (64.1 卤9.0) years. Methods all the doctors involved were trained, investigated according to the unified requirements and filled out the questionnaire. At the same time, the patients were examined by physical examination and related laboratory examination. The HbA1c was measured by the high pressure liquid chromatography (HPLC) instrument of Burle Company, USA. A photograph of the posterior polar fundus was taken from all patients with 45 掳pupil free color fundus camera. The severity of DR was compared with the Airlie House classification method. ROC curve was used to analyze the optimal threshold of DR diagnosis by HbA1c. Main outcome measures: diagnostic threshold (sensitivity, specificity, AUC).) of HbA1c in DR Results the prevalence rate of DR in this population was (24.7 卤1.0)% (95 CI 22.8c26.6). In binary logistic regression analysis, the occurrence of DR was related to higher HbA1c concentration (OR=1.23;95%CI,1.14~1.33), and the prevalence of DR increased with the increase of HbA1c. When HbA1c 鈮，
本文编号：2287170
[Abstract]:Objective to investigate the relationship between glycosylated hemoglobin (HbA1c) and diabetic retinopathy (DR) and its diagnostic threshold. Design a cross-sectional study based on community population. Participants 2642 patients with type 2 diabetes between 20 and 80 years of age were enrolled in the Beijing community diabetes study. 2007 (76.0%) subjects (1199 women) participated in the study, with an average age of (64.1 卤9.0) years. Methods all the doctors involved were trained, investigated according to the unified requirements and filled out the questionnaire. At the same time, the patients were examined by physical examination and related laboratory examination. The HbA1c was measured by the high pressure liquid chromatography (HPLC) instrument of Burle Company, USA. A photograph of the posterior polar fundus was taken from all patients with 45 掳pupil free color fundus camera. The severity of DR was compared with the Airlie House classification method. ROC curve was used to analyze the optimal threshold of DR diagnosis by HbA1c. Main outcome measures: diagnostic threshold (sensitivity, specificity, AUC).) of HbA1c in DR Results the prevalence rate of DR in this population was (24.7 卤1.0)% (95 CI 22.8c26.6). In binary logistic regression analysis, the occurrence of DR was related to higher HbA1c concentration (OR=1.23;95%CI,1.14~1.33), and the prevalence of DR increased with the increase of HbA1c. When HbA1c 鈮，
本文编号：2287170
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