The relation of markers of inflammation and endothelial dysfunction to the prevalence and progression of diabetic retinopathy: Wisconsin epidemiologic study of diabetic retinopathy.
The relation of markers of inflammation and endothelial dysfunction to the prevalence and progression of diabetic retinopathy: Wisconsin epidemiologic study of diabetic retinopathy.
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DOI：
10.1001/archophthalmol.2009.172
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发表时间：
2009-09
影响因子：
--
通讯作者：
Klein, Ronald
中科院分区：
文献类型：
--
作者：
Klein, Barbara E. K.;Knudtson, Michael D.;Tsai, Michael Y.;Klein, Ronald
糖尿病视网膜病变的患病率和发病率与血糖、血压和血清总胆固醇水平有关。据报道，全身炎症和内皮功能障碍的标志物可能是重要的额外风险因素。确定炎症和内皮功能障碍的几种全身标志物与长期1型糖尿病患者糖尿病视网膜结局的患病率和发生率的相关性。对1978-1979年在威斯康星州中南部接受糖尿病治疗的1型糖尿病患者进行的纵向人群研究。这项调查的数据是从1990-1992年到2005-2007年。糖尿病视网膜病变和黄斑水肿的严重程度。在1990-1992年的患病率数据中，可溶性血管细胞粘附分子（sVCAM-1）、肿瘤坏死因子α（TNF-α）和同型半胱氨酸（Hcy）与更严重视网膜病变的几率增加相关（比值比[最高与最低四分位数] 2.43，95%置信区间1.56，3.78; 3.14 [1.98，4.99]; 3.79 [2.33，6.15]），同时控制相关混杂因素。在增殖性糖尿病视网膜病变中也发现了类似的几率。只有同型半胱氨酸与黄斑水肿的几率增加相关（4.68; 1.25-17.57），与肾脏疾病无关。这些标记物均与15年后增殖性视网膜病变、黄斑水肿或视网膜病变进展的发生率无关。有限数量的标记物与1型糖尿病和肾脏疾病患者普遍视网膜结果的几率增加相关。在有无肾脏疾病的患者中，只有同型半胱氨酸与黄斑水肿相关。在没有肾脏疾病的情况下，这些标记物不会增加1型糖尿病患者糖尿病视网膜病变的更常规的描述符和预测因子。这可能反映了糖尿病视网膜病变和糖尿病肾病的密切联系。
Levels of glycemia, blood pressure, and serum total cholesterol are associated with prevalence and incidence of diabetic retinopathy. It has been reported the markers of systemic inflammation and endothelial dysfunction may be important additional risk factors. To determine the association of several systemic markers of inflammation and endothelial dysfunction to prevalence and incidence of diabetic retinal outcomes in persons with long duration type 1 diabetes. Longitudinal population based study of persons with type 1 diabetes who were receiving care for their diabetes in south central Wisconsin in 1978-1979. Data for this investigation were from 1990-1992 through 2005-2007. Severity of diabetic retinopathy and macular edema. In prevalence data from 1990-1992, soluble vascular cell adhesion molecule (sVCAM-1), tumor necrosis factor alpha (TNF-α) and homocysteine (Hcy) were associated with increased odds of more severe retinopathy (Odds ratios [highest versus lowest quartile] 2.43, 95% Confidence Interval 1.56, 3.78; 3.14 [1.98, 4.99]; 3.79 [2.33, 6.15], respectively) in those with kidney disease while controlling for relevant confounders. Similar odds were found for proliferative diabetic retinopathy. Only homocysteine was associated with increased odds of macular edema (4.68; 1.25-17.57) irrespective of kidney disease. None of the markers were associated with incidence of proliferative retinopathy, macular edema, or progression of retinopathy 15 years later. A limited number of markers was associated with increased odds of prevalent retinal outcomes in persons with type 1 diabetes and kidney disease. Only Hcy was associated with macular edema in those with and without kidney disease. In the absence of kidney disease the markers do not add to the more conventional descriptors and predictors of diabetic retinopathy in persons with type 1 diabetes. This may reflect the close association of diabetic retinopathy and diabetic kidney disease.
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影响因子：
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作者：
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通讯作者：
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DOI：
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发表时间：
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DOI：
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1994-12-01
影响因子：
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