eGFR作为糖尿病视网膜病变预警因子的研究

发布时间：2018-11-17 15:33

【摘要】：目的评价糖尿病患者中糖尿病视网膜病变(diabetic retinopathy,DR)的患病率及其与肾小球滤过率(glomerular filtration rate,GFR)的相互关系,探讨eGFR(estimated GFR)作为DR预警因子的可行性。方法 1613例2型糖尿病(type 2 diabetes mellitus,T2DM)患者参与本研究。所有研究对象均自愿接受生物化学和眼部检查。DR由眼科医师通过眼底镜检查和眼底照相确诊。通过易尔统计分析软件评估DR与eGFR之间的关系。结果 1613例糖尿病患者中,DR患病率为34.10%(550例)。将有无DR的患者分组比较,DR组与NDR组差异有统计学意义的变量有:年龄、DM病程、DM家族史、空腹及餐后2 h血糖、糖化血红蛋白、总胆固醇、收缩压、eGFR、血清肌酐及高、低密度脂蛋白胆固醇。Logistic回归分析结果显示,年龄、DM病程、血浆糖化血红蛋白、收缩压、舒张压、eGFR以及高密度脂蛋白胆固醇为DR的独立危险因素,其中eGFR与DR呈负相关。经调整后的饱和效应分析结果表明当eGFR99.4 mL·min-1时,糖尿病患者患DR的风险明显增加。结论 eGFR与DR负相关,eGFR为99.4 mL·min-1是预测DR发生的关键点。检测和评价这一因素对于DR的早期发现具有极其重要的临床意义。
[Abstract]:Objective to evaluate the prevalence of diabetic retinopathy (diabetic retinopathy,DR) and its relationship with glomerular filtration rate (glomerular filtration rate,GFR) in diabetic patients and to explore the feasibility of eGFR (estimated GFR) as an early warning factor for DR. Methods 1613 patients with type 2 diabetes mellitus (type 2 diabetes mellitus,T2DM) were involved in this study. All subjects volunteered for biochemical and ocular examinations. DR was confirmed by ophthalmologists through fundus examinations and fundus photography. The relationship between DR and eGFR was evaluated by means of the Eill statistical analysis software. Results the prevalence of DR was 34.10% (550 cases) in 1613 diabetic patients. Patients with or without DR were divided into two groups: age, course of DM, family history of DM, fasting and 2 h postprandial blood glucose, glycosylated hemoglobin, total cholesterol, systolic blood pressure, serum creatinine and high eGFR,. Logistic regression analysis showed that age, course of DM, plasma glycosylated hemoglobin, systolic blood pressure, diastolic blood pressure, eGFR and high density lipoprotein cholesterol were independent risk factors for DR. EGFR was negatively correlated with DR. The adjusted saturation effect analysis showed that the risk of DR was significantly increased in diabetic patients with eGFR99.4 mL min-1. Conclusion there is a negative correlation between eGFR and DR, and a eGFR of 99.4 mL min-1 is the key point to predict the occurrence of DR. Detection and evaluation of this factor is of great clinical significance for early detection of DR.
【作者单位】：中国医科大学附属第一医院眼科;
【分类号】：R587.2;R774.1

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