Analysis The Risk Factors Of The Occurrence Of Diabetic Retinopathy Among The Middle-aged And Elderly Patients With Type 2 Diabetes Mellitus In Dalian Community

Objective To investigate the risk factors of diabetic retinopathy in the middle-aged and elderly patients with type 2 diabetes mellitus in Dalian community.Methods This retrospective study collected the data of Dalian community residents aged 40 or over,according to the REACTION project initiated by the Chinese Medical Association from August 2011 to December 2011,life history,smoking history and family history of diabetes mellitus were collected.Fasting plasma-glucose,2h postprandial plasma-glucose,Hb A1 c,triglyceride,total cholesterol,high-density and low-density lipoprotein cholesterol,fasting insulin and urine microalbumin were tested.Height,weight,systolic blood pressure,diastolic blood pressure,heart rate were measured.The average blood pressure,average heart rate,BMI and HOMA-IR were calculated.Examed the ocular fundus According to the examination of the ocular fundus,patients were divided into non-diabetic retinopathy,background diabetic retinopathy and proliferative diabetic.1360 patients who had a history of type 2 diabetes while the fundus examination result was NDR were included,1245 patients were follwed up during the period from July 2014 to December 2014,the follow-up rate was 91.5%.Excluding incomplete follow-up patients,eventually 1108 patients were included in this study,the measurements were based on baseline data three years ago.Investigate the risk factors of diabetic retinopathy in the middle-aged and elderly patients with type 2diabetes mellitus in Dalian community.Results1.Until follow-up time was 3 years later,there were 351 patients with DR,the prevalence of DR was 31.7%.332 patients were BDR,19 patients were PDR,the prevalence of BDR was 30.0%,the prevalence of PDR was 1.7%.2.The history of diabetes mellitus,FPG,OGTT 2hPG,HbA1 c,gender,family history of diabetes mellitus,HOMA-IR and UACR were differences between DR and NDR,while MSBP,MDBP,HDL-C,LDL-C,TG and TC were not.3.With the history of diabetes mellitus,FPG,OGTT 2hPG,HbA1 c,gender,family history of diabetes mellitus,HOMA-IR and UACR as the independent variable,and DR as the dependent variable,Logistic regression analysis was conducted.It showed that the history of diabetes mellitus and Hb A1 c were the independent risk factors for DR,while,no family history of diabetes mellitus and female were protective factors for DR.The OR was 1.090,1.342,0.605,0.619,respectively.The P was0.000,0.000,0.003,0.001,respectively.4.The old,MSBP,heart rate,LDL-C and TC were difference between BDR and PDR.5.With the old,MSBP,heart rate,LDL-C and TC as the independent variable,and PDR as the dependent variable,Logistic regression analysis was conducted,It showed that heart rate and LDL-C were the independent risk factors for PDR.The OR was1.105、2.153.The P was 0.042、0.001.Conclusions1.The history of diabetes mellius and Hb A1 c were the independent risk factors for DR,while,no family history of diabetes mellius and female were protective factors for DR.2.LDL-C,heart rate were the independent risk factors for PDR.