Incidence and progression of diabetic retinopathy in Japanese adults with type 2 diabetes: 8 year follow-up study of the Japan Diabetes Complications Study (JDCS)
Incidence and progression of diabetic retinopathy in Japanese adults with type 2 diabetes: 8 year follow-up study of the Japan Diabetes Complications Study (JDCS)
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DOI：
10.1007/s00125-011-2199-0
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发表时间：
2011-09-01
期刊：
影响因子：
8.2
通讯作者：
Yamashita, H.
中科院分区：
文献类型：
--
作者：
Kawasaki, R.;Tanaka, S.;Yamashita, H.
本研究的目的是确定日本 2 型糖尿病患者糖尿病视网膜病变的发病率和进展率及其关联。这是日本糖尿病并发症研究 (JDCS) 的一部分，该研究是一项对 40-70 岁 2 型糖尿病患者进行 8 年随访的多中心随机试验。基线时有 1,221 名患者没有糖尿病视网膜病变；糖尿病视网膜病变的发生率定义为任何糖尿病视网膜病变的发生。基线时有 410 名患者患有轻度非增殖性糖尿病视网膜病变；糖尿病视网膜病变的进展定义为发展为严重的非增殖性糖尿病视网膜病变或增殖性糖尿病视网膜病变。我们使用多变量比例Cox风险模型，并应用广义相加模型来识别潜在的阈值效应。糖尿病视网膜病变的发病率和进展率分别为38.3/1,000人年和21.1/1,000人年。 HbA(1c) 较高（调整后 HR [aHR] 每 1% [10.9 mmol/mol] 1.36 [95% CI 1.28-1.45]）、糖尿病病程较长（每 5 年 aHR 1.26 [95% CI 1.17-1.35]）、收缩压较高（aHR 每 +10 mmHg 1.01 [95% CI 1.01] 1.00-1.02]）和较高的体重指数（aHR 每 1 kg/m(2) 1.05 [95% CI 1.00-1.09]）与糖尿病视网膜病变的发生相关。 HbA(1c) 与糖尿病性视网膜病变之间呈线性相关。与糖尿病病程的关联在 5 至 10 年间迅速增加。较高的 HbA(1c) 也与糖尿病视网膜病变的进展相关（aHR 每 1% [10.9 mmol/mol] 1.66 [95% CI 1.41-1.96]）。观察到的糖尿病视网膜病变的发病率和进展率似乎低于西方人群。 HbA(1c) 是与糖尿病视网膜病变的发生和进展相关的唯一因素。糖尿病病程与糖尿病视网膜病变发病率之间的关联强度在糖尿病病程 5 至 10 年期间迅速增加。
The aim of this study was to determine the incidence and progression rates of diabetic retinopathy and their associations in Japanese individuals with type 2 diabetes.This is a part of the Japan Diabetic Complications Study (JDCS), a multi-centred randomised trial of type 2 diabetes patients aged 40-70 years with an 8 year follow-up. There were 1,221 patients without diabetic retinopathy at baseline; incidence of diabetic retinopathy was defined as the development of any diabetic retinopathy. There were 410 patients with mild non-proliferative diabetic retinopathy at baseline; progression of diabetic retinopathy was defined as the development of severe non-proliferative diabetic retinopathy or proliferative diabetic retinopathy. We used multivariate proportional Cox hazard models, and generalised additive models were also applied to identify potential threshold effect.The incidence and progression rate of diabetic retinopathy was 38.3/1,000 person-years and 21.1/1,000 person-years, respectively. Higher HbA(1c) (adjusted HR [aHR] per 1% [10.9 mmol/mol] 1.36 [95% CI 1.28-1.45]), longer duration of diabetes (aHR per 5 year period 1.26 [95% CI 1.17-1.35]), higher systolic blood pressure (aHR per +10 mmHg 1.01 [95% CI 1.00-1.02]) and higher body mass index (aHR per 1 kg/m(2) 1.05 [95% CI 1.00-1.09]) were associated with incident diabetic retinopathy. The association between HbA(1c) and incident diabetic retinopathy was linear; the association with duration of diabetes increased rapidly between 5 and 10 years. Higher HbA(1c) was also associated with progression of diabetic retinopathy (aHR per 1% [10.9 mmol/mol] 1.66 [95% CI 1.41-1.96]).Observed incidence and progression rates of diabetic retinopathy seemed lower than that in western populations. HbA(1c) was the only factor associated with both incidence and progression of diabetic retinopathy. The strength of the association between duration of diabetes and incidence of diabetic retinopathy increased rapidly during a period of 5 to 10 years duration of diabetes.