GLYCOSYLATED HEMOGLOBIN PREDICTS THE INCIDENCE AND PROGRESSION OF DIABETIC-RETINOPATHY
GLYCOSYLATED HEMOGLOBIN PREDICTS THE INCIDENCE AND PROGRESSION OF DIABETIC-RETINOPATHY
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DOI：
10.1001/jama.260.19.2864
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发表时间：
1988-11-18
影响因子：
120.7
通讯作者：
DEMETS, DL
中科院分区：
文献类型：
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作者：
KLEIN, R;KLEIN, BEK;DEMETS, DL
在威斯康星州的一项基于人群的研究中，研究了最初检查时通过糖化血红蛋白测量的高血糖与糖尿病视网膜病变四年的发病率和进展之间的关系。参加基线和后续检查的年轻患者(n=891)和老年患者(n=987)也包括在内。用微柱法测定糖化血红蛋白。视网膜病变由立体眼底照片确定。在年轻发病组中，比较糖化血红蛋白的最高和最低四分位数，患任何糖尿病视网膜病变的相对风险为1.9，增殖性视网膜病变的相对风险为21.8，进展的相对风险为4.0。在服用胰岛素的老年患者中，相应的相对风险分别为1.9、4.0和2.1。在没有服用胰岛素的老年患者中，任何视网膜病变的相对风险为4.0，进展的相对风险为6.2。在控制了糖尿病病程、年龄、性别和基线视网膜病变后，视网膜病变的发生率和进展与糖化血红蛋白之间仍然存在正相关。这些数据表明，高血糖与视网膜病变的发生和进展之间存在强烈而一致的关系。
The relationship between hyperglycemia, measured by glycosylated hemoglobin at the initial examination, and the four-year incidence and progression of diabetic retinopathy was examined in a population-based study in Wisconsin. Younger-(n = 891) and older-onset (n = 987) persons participating in baseline and follow-up examinations were included. Glycosylated hemoglobin was measured by microcolumn. Retinopathy was determined from stereoscopic fundus photographs. In the younger-onset group, comparing the highest with the lowest quartile of glycosylated hemoglobin, the relative risk for developing any diabetic retinopathy was 1.9; for proliferative retinopathy, 21.8; and for progression, 4.0. Among older-onset persons taking insulin, the corresponding relative risks were 1.9, 4.0, and 2.1. Among older-onset persons not taking insulin, relative risks were 4.0 for any retinopathy and 6.2 for progression. A positive relationship between incidence and progression of retinopathy and glycosylated hemoglobin remained after controlling for duration of diabetes, age, sex, and baseline retinopathy. These data suggest a strong and consistent relationship between hyperglycemia and incidence and progression of retinopathy.