Is the risk of diabetic retinopathy greater in non-Hispanic blacks and Mexican Americans than in non-Hispanic whites with type 2 diabetes? A US population study
Is the risk of diabetic retinopathy greater in non-Hispanic blacks and Mexican Americans than in non-Hispanic whites with type 2 diabetes? A US population study
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DOI：
10.2337/diacare.21.8.1230
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发表时间：
1998-08-01
期刊：
影响因子：
16.2
通讯作者：
Byrd-Holt, DD
中科院分区：
文献类型：
--
作者：
Harris, MI;Klein, R;Byrd-Holt, DD
目的：比较美国非西班牙裔白色、非西班牙裔黑人和墨西哥裔美国成年2型糖尿病患者的糖尿病视网膜病变风险，研究设计和方法--在1988- 2005年，对三个种族/民族中年龄大于或等于40岁的人的代表性的基于人口的样本进行了研究。1994年第三次全国健康和营养检查调查。通过病史询问确定诊断糖尿病，通过测量空腹血糖确定未诊断糖尿病。用非散瞳照相机拍摄单眼眼底照片，并采用标准化方案对糖尿病视网膜病变进行分级。视网膜病变的危险因素的信息，通过访谈和标准的实验室procedure.RESULTS -糖尿病视网膜病变的任何病变的人诊断为糖尿病的患病率高46%，在非西班牙裔黑人和84%，在墨西哥裔美国人，与非西班牙裔白人相比。黑人和墨西哥裔美国人也有较高的中度和重度视网膜病变的发病率，以及视网膜病变的许多推定危险因素的水平较高。在未确诊的糖尿病患者中，黑人的视网膜病变患病率较低。在逻辑回归分析中，糖尿病患者的视网膜病变仅与糖尿病严重程度（糖尿病持续时间、HbA（1c）水平、胰岛素和口服药物治疗）和收缩压相关。调整这些因素后，墨西哥裔美国人视网膜病变的风险是非西班牙裔白人的两倍，但非西班牙裔黑人视网膜病变的风险并不高。这些风险是相似的，当人们与未确诊的糖尿病被列入逻辑回归models.CONCLUSIONS -糖尿病视网膜病变的患病率和严重程度是更大的非西班牙裔黑人和墨西哥裔美国人与2型糖尿病在美国人口比非西班牙裔白人。对于黑人来说，这可以归因于他们更高水平的视网膜病变风险因素，但墨西哥裔美国人的过度风险无法解释。
OBJECTIVE - To compare the risk for diabetic retinopathy in non-Hispanic white, non-Hispanic black, and Mexican-American adults with type 2 diabetes in the U.S, population.RESEARCH DESIGN AND METHODS - Representative population-based samples of people aged greater than or equal to 40 years in each of the three racial/ethnic groups were studied in the 1988-1994 Third National Health and Nutrition Examination Survey (NHANES III). Diagnosed diabetes was ascertained by medical history interview and undiagnosed diabetes by measurement of fasting plasma glucose. A fundus photograph of a single eye was taken with a nonmydriatic camera, and a standardized protocol was used to grade diabetic retinopathy. Information on risk factors for retinopathy was obtained by interview and standard laboratory procedures.RESULTS - Prevalence of any lesions of diabetic retinopathy in people with diagnosed diabetes was 46% higher in non-Hispanic blacks and 84% higher in Mexican Americans, compared with non-Hispanic whites. Blacks and Mexican Americans also had higher rates of moderate and severe retinopathy and higher levels of many putative risk factors for retinopathy. Blacks had lower retinopathy prevalence among those with undiagnosed diabetes. In logistic regression, retinopathy in people with diagnosed diabetes was associated only with measures of diabetes severity (duration of diabetes, HbA(1c) level, treatment with insulin and oral agents) and systolic blood pressure. After adjustment for these factors, the risk of retinopathy in Mexican Americans was twice that of non-Hispanic whites, but non-Hispanic blacks were not at higher risk for retinopathy. These risks were similar when people with undiagnosed diabetes were included in the logistic regression models.CONCLUSIONS - The prevalence and severity of diabetic retinopathy is greater in non-Hispanic blacks and Mexican Americans with type 2 diabetes in the U.S. population than in non-Hispanic whites. For blacks, this can be attributed to their higher levels of risk factors for retinopathy, but the excess risk in Mexican Americans is unexplained.