Research Of The Related Factors Of Diabetic Retinopathy In Type 2 Diabetes Mellitus

Objectives:1.To compare the differences of the clinically relevant factors between type 2 diabetes mellitus(T2DM)patients with and without diabetic retinopathy(DR).2.To explore the risk factors and protective factors of DR in patients with T2DM.Methods:We consecutively enrolled the patients with a definite diagnosis of T2DM from the Endocrinology Department of the Fourth Affiliated Hospital of Kunming Medical University,from January 2015 to December 2018.According to the enrollment conditions,we finally enrolled 754 patients.All these patients were divided into control group(NDRgroup)with 374 no diabetic retinopathy patients and case group(DR group)with 380 diabetic retinopathy patients based on funduscopy.The clinical data of two groups of subjects were collected separately,including the general information,the results of hematological examination and metabolic indicators,the related examination indexes of the diabetic complications and comorbidities,and whether to combine other complications and comorbidities of diabetes.The above factors in the four parts were compared respectively between the two groups,then the correlation that between the above factors and DR was analyzed,and the risk factors and protective factors of DR in patients with T2DM was explored.SPSS 22.0 software was used to statistical analysis.Results:1.In the study population,age(OR=1.152,95%CI:1.066-1.244)and family history of DM(OR=1.559,95%CI:1.091-2.227)were independent risk factors of DR;However,degree of education(OR=0.531,95%CI:0.545-0.620)and age of onset of diabetes mellitus(OR=0.843,95%CI:0.779-0.912)are independent protective factors of DR(P<0.05).2.It can be seen from the correlation analysis between DR and the results hematological examination,neutrophil-to-lymphocyte ratio(NLR)(OR=3.420,95%CI:1.704-6.865)was an independent risk factor for DR,while Platelet-to-lymphocyte ratio(PLR)(OR=0.976,95%CI:0.959-0.993)was an independent protective factor for DR(P<0.05).At the same times,according to the correlation analysis between DR and metabolic index,blood glucose fluctuation coefficient(BGFC)(OR=1.664,95%CI:1.217-2.275),total cholesterol(TC)(OR=1.422,95%CI:1.026-1.970)and blood urea nitrogen(BUN)(OR=1.432,95%CI:1.126-1.820)are independent risk factors for DR(P<0.05).3.Through the correlation analysis between DR and the related examination indexes of diabetic complications and comorbidities,we can find that resting heart rate(RHR)(OR=1.035,95%CI:1.004-1.068)is an independent risk factors of DR(P<0.05).4.After analyzing the correlation between DR and other complications and comorbidities of diabetes,we learned that diabetic nephropathy(DN)(OR=3.555,95%CI:2.381-5.306),diabetic peripheral neuropathy(DPN)(OR=1.684,95%CI:1.134-2.499),lower extremity arteriosclerosis disease(LEAD)(OR=2.629,95%CI:1.840-3.757)and essential hypertension(EH)(OR=1.453,95%CI:1.021-2.068)are all independent risk factors for DR(P<0.05).Conclusions:1.Elder,positive family history of diabetes,and higher NLR,BGFC,TC,BUN levels,faster RHR,as well as,combined DN,DPN,LEAD and EH were increasing the risk of DR.2.Higher degree of education,late onset of diabetes mellitus,and higher PLR levels reduced the risk of DR.3.In the prevention and management of DR,we need delicacy management of risk factors and protective factors for DR,to make best use of advantages and avoid the weaknesses,and to strive for more comprehensive and reasonable intervention of the occurrence and development of DR.