Analysis Of Related Factors Of Type 2 Diabetic Retinopathy

Objective:To explore the relevant influencing factors of type 2 diabetic retinopathy and provide theoretical basis for the early diagnosis,prevention and treatment of diabetic retinopathy.Methods: 1.Retrospective analysis of 120 patients(240 eyes)with type 2 diabetes(T2DM)admitted to our hospital from January 2016 to January 2017,according to the new international clinical classification criteria for diabetic retinopathy(2002)40 patients(80 eyes)without diabetic retinopathy(NDR),40 patients(80 eyes)with mild-to-moderate non-proliferative diabetic retinopathy(mild-moderate NPDR),and severe non-proliferative diabetic retinopathy(In 40 cases(80 eyes)with severe NPDR,40 healthy subjects(80 eyes)were selected as the control group.Clinical data collected for each group included age,gender,body mass index(BMI),diabetes duration,and blood pressure.Biochemical indicators: FPG,HbA1 C,TC,apoA1,TG,apoB,LDL cholesterol LDL-C),high-density lipoprotein cholesterol(HDL-C),glomerular filtration rate(GFR),serum creatinine(Scr),fibrinogen(FIB),activated partial thromboplastin time(APTT)and urine Micro Albumin to Creatinine Ratio(UACR).At the same time,patients' ophthalmic data were collected: uncorrected visual acuity,corrected visual acuity,intraocular pressure,eye examination,fundus photography,macular OCT,optic disc nerve fiber thickness,fundus fluorescein angiography,and history of eye diseases.For the continuous variable,if the data follows a normal distribution,the statistical description is represented by s.The comparison between multiple groups is based on the analysis of single-factor variance,and the pairwise comparison uses the LSD-t test.If the normal distribution is not met,then a rank-based non-parametric test is selected.Spearman rank correlation analysis and linear-ordered logistic regression were used to analyze the relationship between diabetic retinal severity and other clinical parameters.2.Retrospective analysis of 90 patients(180 eyes)with type 2 diabetes(T2DM)admitted to our hospital from January 2017 to December 2017,according to the new international clinical classification criteria for diabetic retinopathy(2002)30 patients(60 eyes)without diabetic retinopathy(NDR),30 patients(60 eyes)with mild-to-moderate non-proliferative diabetic retinopathy(mild-moderate NPDR),and severe non-proliferative diabetic retinopathy(30 cases(60 eyes)of severe NPDR were selected,and 30 healthy people(60 eyes)were selected as the control group.The clinical data collected in each group included age,gender,diabetes duration,Body Mass Index(BMI),and blood pressure.Biochemical indicators: fasting plasma glucose(FPG),glycated hemoglobin(HbA1C),urine microalbumin and creatinine ratio(UACR).At the same time,patients' eye data were collected,including uncorrected visual acuity,corrected visual acuity,intraocular pressure,eye examination,fundus photography,macular ganglion cell complex thickness(mGCC),retinal nerve fiber layer thickness,fundus fluorescein angiography,and history of eye diseases.And other information.The statistical method is the same as before.Results:1.With the increase of DR severity,the course of diabetes,FPG,HbA1 c,TC,TG,LDL-C,UACR,Scr,FIB showed an increasing trend,and the difference was statistically significant(P<0.05).GFR showed a decreasing trend.Statistically significant(P<0.05).The changes of age,BMI,apoaA1,apoAB,and APTT were not significant,and the difference was not statistically significant(P>0.05).Spearman rank correlation analysis showed that the severity of DR was positively correlated with the duration of diabetes,FPG,HbA1 c,TC,TG,LDL-C,UACR,Scr,FIB,and had the strongest correlation with diabetes duration,HbA1 c,FPG,and UACR.Negatively related to GFR.There was no significant correlation with other items(P>0.05).Linear-ordered logistic regression analysis showed that the severity of DR in patients with type 2 diabetes was related to the duration of diabetes,HbA1 c,UACR,and Scr levels.The odds of diabetes course,HbA1 c,UACR,and Scr levels at least one level of diabetes were 0.631(P=0.003)and 0.383(P=0.001)in the nondiabetic retinopathy group,the mild to moderate NPDR group,and the severe NPDR group,respectively.,0.931(P=0.000),0.935(P=0.016)times.2.Compared with the control group,NDR group,mild,moderate NPDR group,severe NPDR group,with the increase of DR severity,the duration of diabetes,FPG,HbA1 c,UACR showed an increasing trend,the difference was statistically significant(P<0.05)).With the increase of DR severity,the thickness of mGCC in all groups became thinner,and the difference was statistically significant(P<0.05).The Spearman rank correlation analysis of DR severity and mGCC thickness in each group showed that DR severity was negatively correlated with mGCC and was most strongly correlated with mean,upper,upper nasal and inferior nasal mGCC thickness.Linear-ordered logistic regression analysis showed that the severity of DR in patients with type 2 diabetes was related to the patient's mGCC thickn ess in the 4:00 zone.In the non-diabetic retinopathy group,the mild-to-moderate NPDR group and the severe NPDR group had a 1.28-fold lower probability of ha ving at least one level of mGCC thickness lower than the 4:00 area.Conclusion:1.Diabetes duration,FPG,HbA1 c,TC,TG,HDL-C,LDL-C,apoB,UACR,GFR,FIB,and APTT are related factors of DR in patients with type 2 diabetes,further demonstrating that DR is a combination of multiple factors.result.2.Patients with diabetes should be tested for UACR and mGCC early.The higher the level of UACR and the more pronounced the thinning of the mGCC,the more likely it is that DR will occur.3.UACR and mGCC can be used as clinical predictors of DR in patients with type 2 diabetes to guide clinical prevention and treatment in time to prevent the occurrence and development of DR.