Higher prevalence of retinopathy in diabetic patients of South Asian ethnicity compared with white Europeans in the community: a cross-sectional study.
Higher prevalence of retinopathy in diabetic patients of South Asian ethnicity compared with white Europeans in the community: a cross-sectional study.
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DOI：
10.2337/dc08-1422
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发表时间：
2009-03
期刊：
影响因子：
16.2
通讯作者：
UK Asian Diabetes Study Retinopathy Study Group
中科院分区：
文献类型：
--
作者：
Raymond NT;Varadhan L;Reynold DR;Bush K;Sankaranarayanan S;Bellary S;Barnett AH;Kumar S;O'Hare JP;UK Asian Diabetes Study Retinopathy Study Group
这项研究的目的是比较英国糖尿病视网膜病变的患病率和危险因素。南亚或白色欧洲种族的居民。研究设计和方法--这是一项以社区为基础的横断面研究，涉及10个全科诊所;研究了1,035名2型糖尿病患者：421名南亚人和614名白色欧洲人。对视网膜照片进行分级后，对糖尿病视网膜病变、威胁视力的视网膜病变、黄斑病变和既往激光光凝治疗进行评估。收集了包括年龄、病程、糖尿病治疗、血压、血清总胆固醇和A1 C在内的风险因素的数据。南亚种族患者的收缩压（144 vs. 137 mmHg，P < 0.0001）和舒张压（84 vs. 74 mmHg，P < 0.0001）、A1 C（7.9 vs. 7.5%，P < 0.0001）和总胆固醇（4.5 vs. 4.2 mmol/l，P < 0.0001）显著较高。在414例（40%）患者中检测到糖尿病视网膜病变（189例南亚人[45%] vs 225例白色欧洲人[37%]; P = 0.0078）。在142例（14%）患者中检测到威胁视力的视网膜病变（68例南亚人[16%] vs 74例白色欧洲人[12%]; P = 0.0597）。调整混杂因素后，南亚患者发生视网膜病变和黄斑病变的风险显著高于欧洲白色患者。结论：南亚种族患者糖尿病视网膜病变和黄斑病变的患病率显著较高，收缩压和舒张压、A1 C和总胆固醇显著升高;达到年龄较低;诊断时年龄较小。发病较早和可改变的风险因素水平较高，使早期发现糖尿病，每年转诊进行视网膜筛查，以及强化风险因素控制成为解决这种健康不平等的关键因素。
OBJECTIVE—The purpose of this study was to compare prevalence and risk factors for diabetic retinopathy among U.K. residents of South Asian or white European ethnicity. RESEARCH DESIGN AND METHODS—This was a community-based cross-sectional study involving 10 general practices; 1,035 patients with type 2 diabetes were studied: 421 of South Asian and 614 of white European ethnicity. Diabetic retinopathy, sight-threatening retinopathy, maculopathy, and previous laser photocoagulation therapy were assessed after grading of retinal photographs. Data were collected on risk factors including age, duration, and treatment of diabetes, blood pressures, serum total cholesterol, and A1C. RESULTS—Patients of South Asian ethnicity had significantly higher systolic (144 vs. 137 mmHg, P < 0.0001) and diastolic (84 vs. 74 mmHg, P < 0.0001) blood pressure, A1C (7.9 vs. 7.5%, P < 0.0001), and total cholesterol (4.5 vs. 4.2 mmol/l, P < 0.0001). Diabetic retinopathy was detected in 414 (40%) patients (189 South Asian [45%] versus 225 white European [37%]; P = 0.0078). Sight-threatening retinopathy was detected in 142 (14%) patients (68 South Asian [16%] versus 74 white European [12%]; P = 0.0597). After adjustment for confounders, there were significantly elevated risks of any retinopathy and maculopathy for South Asian versus white European patients. CONCLUSIONS—Patients of South Asian ethnicity had a significantly higher prevalence of diabetic retinopathy and maculopathy, with significantly elevated systolic and diastolic blood pressure, A1C, and total cholesterol; lower attained age; and younger age at diagnosis. Earlier onset of disease and higher levels of modifiable risk factors make early detection of diabetes, annual referral for retinal screening, and intensive risk factor control key elements in addressing this health inequality.
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