Risk Factors Affecting The Development Of Type 2 Diabetic Retinopathy And ROC Curve Analysis For Prediction

Objective: The aim of this study was to investigate the hemodynamic characteristics of the central retinal artery central retinal artery(CRA)in patients with type 2 diabetic retinopathy(DR)using color Doppler imaging(CDI)technology,exploring the related risk factors for the occurrence and development of DR,and providing simple and reliable indicators for DR screening to detect its occurrence early and take appropriate treatment measures to delay its progression.Methods: Cross-sectional study was used in this paper.Ninety patients with type 2diabetes were included in this study and divided into four groups: the non-diabetic retinopathy group(NDR group,n=30),non-proliferative diabetic retinopathy group(NPDR group,n=30),proliferative diabetic retinopathy group(DR group,n=30),and healthy control group(n=30).The non-proliferative diabetic retinopathy group,which has divided into two groups(Mild and moderate non-proliferative diabetic retinopathy,mNPDR)and another group for patients with sever DR(Severe non-proliferative diabetic retinopathy,sNPDR).CDI was used to examine the hemodynamic changes of the CRA and measure the intima-media thickness(ICA-IMT)and plaques of the ipsilateral carotid artery.The changes in hemodynamic parameters of CRA,such as peak systolic velocity(PSV),resistance index(RI),and pulsatility index(PI),were observed and collected for each group.Additionally,age,gender,body mass index(BMI),fasting blood glucose(FBG),triglycerides(TG),total cholesterol(TC),lowdensity lipoprotein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C)were collected,and the medical histories of hyperlipidemia,smoking,and alcohol consumption were recorded for each group.Univariate ordered logistic regression analysis and multivariate ordered logistic regression analysis were used to identify the risk factors for DR and calculate the odds ratios(ORs)and 95% confidence intervals(CIs).The relevant risk factors were evaluated using ROC curve analysis.Results:1.There were no significant differences in gender,age,BMI,smoking,and alcohol consumption among the four groups(P>0.05).2.There were significant differences in PSV among the four groups(P=0.000),and the blood flow velocity gradually decreased with the progression of DR.In terms of PI,the order was DR group >NPDR group > control group > NDR group,and the differences in PI among the four groups were statistically significant(P=0.000).In terms of RI,the order was DR group >NPDR group > control group > NDR group,and the differences in RI among the four groups were also statistically significant(P=0.000).3.There were significant differences in PSV between the mNPDR group and the sNPDR group.(P=0.002),while the PI and RI of the sNPDR group were higher than those of the mNPDR group,but there was no significant difference(P>0.05);Compared with the mNPDR and sNPDR groups,the difference in PSV value in the NDR group was statistically significant(P=0.006).The PI and RI in the mNPDR group were higher than those in the NDR group,but there was no significant differences(P>0.05).The PI in the sNPDR group was significantly higher than that in the NDR group,with a significant difference(P<0.001).The RI in the sNPDR group was significantly higher than that in the NDR group,with a significant difference(P<0.05).Compared with the mNPDR and sNPDR groups,there was no statistically significant difference in PSV value between the PDR group and the mNPDR group(P>0.05).The mNPDR group had a lower PI compared to the PDR group,with a significant difference(P<0.001).The mNPDR group had a lower RI compared to the PDR group,with a significant difference(P<0.001).The PI of the sNPDR group was lower than that of the PDR group,with a significant difference(P<0.05).The sNPDR group had a lower RI than the PDR group,with no significant difference(P>0.05).4.There were significant differences in ICA-IMT among the four groups(P=0.000),and ICA-IMT was positively correlated with the progression of DR.Among the 90 patients,54(60%)had carotid plaques,and the detection rate of carotid plaques gradually increased with the progression of DR.5.Univariate ordered logistic regression analysis and multivariate ordered logistic regression analysis identified several predictive factors associated with the occurrence and development of DR,including ICA-IMT,TG,TC,LDL-C,FBG and hyperlipidemia(P<0.05).6.ROC curve analysis showed that PI,TG,TC,LDL-C were sensitive predictors for DR.Conclusions: Our findings suggest that CDI has clinical value in monitoring the hemodynamics of patients with diabetes retinopathy,can be used as a early screening for DR.The occurrence and development of diabetes retinopathy is closely related to the disorder of blood lipid metabolism.It is necessary to strengthen the hypoglycemic and actively intervene in blood lipid to reduce the occurrence and development of diabetes retinopathy.