Link between retinopathy and nephropathy caused by complications of diabetes mellitus type 2
Link between retinopathy and nephropathy caused by complications of diabetes mellitus type 2
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DOI：
10.1007/s10792-014-0018-6
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发表时间：
2015-02-01
影响因子：
1.6
通讯作者：
Levy, Jaime
中科院分区：
文献类型：
--
作者：
Kotlarsky, Pavel;Bolotin, Arkady;Levy, Jaime
虽然糖尿病肾病和视网膜病变的相关性和时间顺序在1型糖尿病患者中是众所周知的，但在2型糖尿病患者中，这种相关性不太清楚。一项包括917例2型糖尿病患者的回顾性研究。糖尿病视网膜病变（DR）的诊断基于眼底照片的非散光相机。糖尿病肾病（DN）的诊断基于尿白蛋白浓度在晨尿样本。采用看似不相关回归（SUR）模型进行统计分析。我们的SUR模型具有统计学显著性：“模型对饱和”的检验为2.20，其显著性水平为0.8205。模型显示肌酐和肾小球滤过率（GFR）对蛋白尿有较强的影响，而体重指数（BMI）和HbA(1)c的影响不显著。DR与糖尿病病程、胰岛素治疗、葡萄糖水平和HbA(1)c呈正相关，与GFR、甘油三酯水平和BMI呈负相关。DR与DN的相关性具有统计学意义，且呈单向相关，可按时间顺序解释；即DN先于dr。本研究表明，肾脏损害程度与眼睛损害程度成正比。此外，这种联系具有时间顺序方面；肾脏损伤先于视网膜损伤。
While the correlation and chronology of appearance of diabetic nephropathy and retinopathy is well known in diabetes mellitus (DM) type 1 patients, in DM type 2 this correlation is less clear. A retrospective study including 917 patients with type 2 diabetes. Diabetic retinopathy (DR) was diagnosed based on fundus photographs taken with a non-mydriatic camera. Diabetic nephropathy (DN) was diagnosed based on urinary albumin concentration in a morning urine sample. Statistical analysis was performed with a seemingly unrelated regression (SUR) model. Our SUR model is statistically significant: the test for "model versus saturated" is 2.20 and its significance level is 0.8205. The model revealed that creatinine and glomerular filtration rate (GFR) have strong influence on albuminuria, while body mass index (BMI) and HbA(1)c have less significant impact. DR is affected positively by diabetes duration, insulin treatment, glucose levels, and HbA(1)c, and it is affected negatively by GFR, triglyceride levels, and BMI. The association between DR and DN was statistically significant and had a unidirectional correlation, which can be explained by chronological order; that is, DN precedes DR. The present study indicates that the level of renal impairment is proportional to the level of damage to the eye. Furthermore, such an association has a chronological aspect; the renal injury precedes retinal damage.