Study On The Prevalence And Correlates Of Diabetic Retinopathy In Type 2 Diabetic Patients

Objective: To evaluate the prevalence and distribution characteristics of diabetic retinopathy(DR) and to explore correlates of DR in patients with type 2 diabetes mellitus(T2DM), so as to provide scientific basis for prevention and control of DR.Methods: Medical records of T2 DM patients hospitalized first time in Metabolic Diseases Hospital, Tianjin Medical University from August 30, 2011 to May 30, 2012 were retrospectively reviewed. Information was collected, including general situation, behavior pattern, disease history and family history, physical examination and laboratory test. The database was established using Epi Data software. Prevalence and distribution characteristics of DR in T2 DM patients were analysed. A case-control study was conducted, in which DR patients were as cases and T2 DM patients with normal retinal examination were as controls, to analyze correlates of DR in T2 DM patients by non-conditional logistic regression and to evaluate the odds ratio(OR) and 95% confidence interval(95% CI).Results: 1. Among 2062 T2 DM patients, 516 were DR patients, the prevalence of DR was 25.0%, in which 497(24.1%) were patients of non-proliferative diabetic retinopathy(NPDR) and 19(0.9%) were patients of proliferative diabetic retinopathy(PDR) respectively. The DR prevalence in female T2 DM patients(27.8%) was significantly higher than that in males(22.8%), and the DR prevalence increased with age and diabetes duration. The NPDR prevalence in female T2 DM patients(27.8%) was higher than that in males(22.0%). There was no statistically significant difference between the PDR prevalence in female T2 DM patients(1.2%) and in males(0.8%). 2. 516 DR patients were used as case group and 1546 T2 DM patients without DR were used as control group. Results of univariate logistic regression analysis showed that the higher risk of DR was associated with female, old age, retirement, smoking, earlier age of diabetes diagnosis, longer duration of diabetes, insulin therapy, hypertension, coronary heart disease, diabetic nephropathy, peripheral neuropathy, diabetic foot and high fibrinogen, family history of diabetes, high SBP and DBP, high BUN, high CRE, high CRP. After adjusting for related factors, age, longer duration of diabetes, insulin therapy, hypertension, diabetic nephropathy, peripheral neuropathy, diabetic foot and high fibrinogen, family history of diabetes, high SBP and DBP, high BUN, high CRE were still statistically associated with the higher risk of DR and fasting C-peptide, postprandial 2h C-peptide were associated with lower risk of DR. 3. Results of multivariate non-conditional logistic regression analysis showed that diabetes duration, diabetic nephropathy and hypertension were associated with higher risk of DR, the OR and 95% CI were 1.885(1.151-3.088), 2.162(1.205-3.878) and 1.905(1.078-3.365) respectively, while postprandial 2h C-peptide was associated with lower risk of DR, the OR(95% CI) was 0.535(0.380-0.753).Conclusions: The DR prevalence in T2 DM patients was 25.0% in the present study, in which the prevalence of NPDR and PDR were 24.1% and 0.9% respectively, and the DR prevalence in female T2 DM patients was higher than that in males, and DR prevalence increased with age and diabetes duration. Diabetes duration, diabetic nephropathy and hypertension were associated with higher risk of DR, and postprandial 2h C-peptides was associated with lower risk of DR.