The prevalence of diabetic retinopathy among adult type 1 diabetic persons in the United States
The prevalence of diabetic retinopathy among adult type 1 diabetic persons in the United States
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DOI：
10.1001/archopht.122.4.546
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发表时间：
2004-04-01
影响因子：
--
通讯作者：
Kempen, JH
中科院分区：
文献类型：
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作者：
Roy, MS;Klein, R;Kempen, JH
目的：估计美国1型糖尿病（DM）患者中糖尿病视网膜病变（DR）的患病率。方法：采用新泽西725和威斯康星州糖尿病视网膜病变流行病学研究的患病率数据，按年龄、性别和种族估计18岁及以上30岁以前诊断为1型DM的患者中DR的患病率。DR的严重程度通过7视野立体眼底照片的掩蔽分级来确定。任何DR被定义为视网膜病变严重程度为14或更高;以及威胁视力的视网膜病变，视网膜病变严重程度为50或更高，存在临床显著的黄斑水肿，或两者兼而有之。将1型DM患者中DR患病率的估计值应用于2000年美国人群中30岁之前诊断的1型DM患者的估计数量，以获得一般人群中1型DM所致DR的患病率估计值。在2.09亿18岁及以上的美国人中，估计有889000人在30岁之前被诊断为1型糖尿病。在1型糖尿病患者中，任何级别的DR（黑人和白色人分别为74.9%和82.3%）和威胁视力的视网膜病变（分别为30.0%和32.2%）的粗患病率都很高。在18岁及以上的一般人群中，由于30岁之前诊断的1型DM导致的DR的患病率估计为767000人患有任何级别的DR（0.37%），376000人患有威胁视力的视网膜病变（0.18%）。1型糖尿病引起的视网膜病变在美国是一个重要的公共卫生问题，每300名18岁及以上的人中就有1人受到影响，每600人中有1人患有严重的威胁视力的视网膜病变。
Objective: To estimate the US prevalence of diabetic retinopathy (DR) among persons with type 1 diabetes mellitus (DM).Methods: Prevalence data from the New Jersey 725 and Wisconsin Epidemiologic Study of Diabetic Retinopathy were used to estimate the prevalence of DR by age, gender, and race among persons 18 years and older having type 1 DM diagnosed before age 30 years. Severity of DR was determined via masked grading of 7-field stereoscopic fundus photographs. Any DR was defined as retinopathy severity level of 14 or more; and vision-threatening retinopathy, as retinopathy severity level of 50 or more, the presence of clinically significant macular edema, or both. The estimates of the prevalence of DR among persons with type 1 DM were applied to the estimated number of persons with type 1 DM diagnosed before age 30 years in the 2000 US population to obtain prevalence estimates of DR due to type 1 DM in the general population.Results: Among 209 million Americans 18 years and older, an estimated 889000 have type 1 DM diagnosed before age 30 years. Among persons with type 1 DM, the crude prevalences of DR of any level (74.9% vs 82.3% in black and white persons, respectively) and of vision-threatening retinopathy (30.0% vs 32.2%, respectively) are high. The prevalence of DR due to type 1 DM diagnosed before age 30 years in the general population 18 years and older is estimated at 767000 persons having DR of any level (0.37%), and 376000 persons having vision-threatening retinopathy (0.18%).Conclusion: Retinopathy due to type 1 DM is an important public health problem in the United States, affecting 1 per 300 persons 18 years and older, and 1 per 600 persons with advanced, vision- threatening retinopathy.