脂代谢异常与糖尿病视网膜病变的相关性分析

发布时间：2018-10-23 13:51

【摘要】：目的：探讨脂代谢异常与糖尿病视网膜病变的相关性。方法：选取2011年8月16号至2011年12月10日期间，在大连市中心医院接受社区糖尿病普查的年龄大于等于40周岁的10300例社区居民，去掉缺项少项共收集到10144例，依据有无糖尿病，有无糖尿病视网膜病变划分成三组，非糖尿病人群（A组），糖尿病无视网膜病变人群（B组），糖尿病视网膜病变人群（C组）。比较三组资料免散瞳眼底照相、年龄、性别、体重、腰围、臀围、空腹血糖、两小时血糖以、糖化血红蛋白、TG、TC、HDL-C、LDL-C等指标，对比分析与糖尿病视网膜病变的相关危险因素。结果： 1、血脂情况:接受社区普查的居民中血脂正常者共4199人，血脂异常者共5945人，血脂异常者占总体人数的58.60%，低HDL-C血症，高LDL-C血症，高TC血症、高TG血症的患病率分别为4.02%、33.42%、38.77%、29.62%。 2、糖尿病脂代谢异常人群视网膜病变的发病率与糖尿病脂代谢正常的人群视网膜病变发病率比较发病率分别为（10.14%vs9.3%, χ2=0.39, P＞0.05）。 3、糖尿病人群中高TG和正常TG水平下糖尿病视网膜病变的发病率比较发病率分别为（9.1%vs10.4%, χ2=1.087, P＞0.05）。 4、糖尿病人群中高TC和正常TC水平下糖尿病视网膜病变的发病率比较发病率分别为（9.9%vs9.8%, χ2=0.007, P＞0.05）。 5、糖尿病人群中高HDL-C和正常HDL-C水平下糖尿病视网膜病变的发病率比较发病率分别为（10.1%vs9.7%, χ2=0.006P＞0.05）。 6、糖尿病人群中高LDL-C和正常LDL-C水平下糖尿病视网膜病变的发病率比较发病率分别为（13.6%vs9.6%, χ2=0.582, P＞0.05）。 7、经非条件多因素logistic回归分析糖化血红蛋白OR=9.1,(95%CI1.175-2.207), P＜0.05，收缩压OR=32.09,(95%CI2.308-5.568), P＜0.05及病程OR=145.49,(95%CI4.373-7.742), P＜0.05。结论： 1.脂质代谢异常与糖尿病DR的发生无相关性。 2.糖化血红蛋白，收缩压及病程参与了糖尿病视网膜病变的发生发展。
[Abstract]:Objective: to investigate the relationship between abnormal lipid metabolism and diabetic retinopathy. Methods: from August 16, 2011 to December 10, 2011, 10300 community residents aged over 40 years were selected for community diabetes census in Dalian central hospital, and 10144 cases were collected according to diabetes. Patients with diabetic retinopathy were divided into three groups: non-diabetic group (group A), diabetic group without retinopathy (group B) and diabetic retinopathy group (group C). The data of the three groups were compared without radiography, age, sex, body weight, waist circumference, hip circumference, fasting blood glucose, two hours blood glucose, glycosylated hemoglobin, TG,TC,HDL-C,LDL-C and so on. The risk factors associated with diabetic retinopathy were compared and analyzed. Results: 1. Blood lipid status: there were 4199 patients with normal blood lipid and 5945 patients with dyslipidemia among the residents who received community census. The patients with dyslipidemia accounted for 58.60% of the total population. The patients with dyslipidemia had low HDL-C, high LDL-C and high TC. The prevalence of hyperlipidemia was 4.02 and 33.42 respectively. The incidence of retinopathy in patients with abnormal lipid metabolism was 29.62. The incidence of retinopathy in patients with abnormal lipid metabolism was higher than that in those with normal lipid metabolism (10.14 vs 9.3, 蠂 2 = 0.39, P > 0. 05). 3. The incidence of diabetic retinopathy in diabetic patients with high TG level and normal TG level were respectively (9.1 vs 10.4, 蠂 ~ 21.087, P > 0.05). 4. In diabetic patients with high TC and normal TC levels, the incidence of diabetic retinopathy was higher than that of normal TC. The incidence of diabetic retinopathy in diabetic patients with high HDL-C level and normal HDL-C level was (10.1 vs 9.7, 蠂 2 + 0.006 P > 0.05). The incidence of diabetic retinopathy in the patients with high LDL-C and normal LDL-C levels was 13.6v 9.6and 蠂 2 0.582, P > 0.05.7.The glycosylated hemoglobin OR=9.1, (95%CI1.175-2.207), P < 0.05) and systolic pressure OR=32.09, (95%CI2.308-5.568), P) were analyzed by non-conditional multivariate logistic regression analysis. < 0. 05 and OR=145.49, (95%CI4.373-7.742), P < 0. 05). Conclusion: 1. There was no correlation between abnormal lipid metabolism and diabetes mellitus DR. 2. Glycosylated hemoglobin, systolic blood pressure and course of disease are involved in the development of diabetic retinopathy.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R587.2;R774.1

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