Population trends in the 10-year incidence and prevalence of diabetic retinopathy in the UK: a cohort study in the Clinical Practice Research Datalink 2004-2014
Population trends in the 10-year incidence and prevalence of diabetic retinopathy in the UK: a cohort study in the Clinical Practice Research Datalink 2004-2014
复制标题
DOI：
10.1136/bmjopen-2016-014444
复制
发表时间：
2017-02-01
期刊：
影响因子：
2.9
通讯作者：
Douglas, Ian
中科院分区：
文献类型：
--
作者：
Mathur, Rohini;Bhaskaran, Krishnan;Douglas, Ian
目的：通过糖尿病类型、年龄、性别、种族、贫困、地区和日历年来描述英国糖尿病视网膜病变（DR）的发病率和患病率趋势。设计：使用临床实践研究数据链（CPRD）的队列研究。设置：英国初级保健。参与者：2004年至2014年，770万例患者= 12例参与CPRD。主要和次要结局指标：按日历年和人群亚组列出的糖尿病、DR和重度DR（需要光凝）的标准化患病率和发病率。结果：1型糖尿病（T1 DM）和2型糖尿病（T2 DM）患者DR患病率分别为48.4%（14846/30657）和28.3%（95807/338390）。DR患病率在T2 DM患者中保持稳定，在T1 DM患者中下降。对于T2 DM患者，DR筛查随时间增加，而对于T1 DM患者，DR筛查保持不变。在两个糖尿病人群中，DR发生率与T2 DM发生率平行增加。在T2 DM患者中，DR的相对风险因地区而异，与女性相比，老年组和男性的DR相对风险增加，南亚组和贫困组的重度DR风险增加。T1 DM患者DR的相对风险因年龄和地区而异，但不受性别，种族或deprivation.Conclusions：这是迄今为止最大的研究DR在英国的负担。发病率的地区差异可能与筛查、分娩和疾病确定方面的差异有关。证据表明，贫困和种族与严重DR的风险较高，突出了一个显着的潜在的健康不平等。这项研究的结果将对在糖尿病和视力丧失领域工作的专业人员产生影响，特别是为视网膜病变的诊断方法提供信息，并为高危人群更好地应对疾病而开展活动。
Objectives: To describe trends in the incidence and prevalence of diabetic retinopathy (DR) in the UK by diabetes type, age, sex, ethnicity, deprivation, region and calendar year.Design: Cohort study using the Clinical Practice Research Datalink (CPRD).Setting: UK primary care.Participants: 7.7 million patients = 12 contributing to the CPRD from 2004 to 2014.Primary and secondary outcome measures: Age-standardised prevalence and incidence of diabetes, DR and severe DR (requiring photocoagulation) by calendar year and population subgroup. Relative risk of developing DR and severe DR by population subgroup.Results: The prevalence of DR was 48.4% in the population type 1 diabetes mellitus (T1DM) (14 846/ 30 657) and 28.3% (95 807/338 390) in the population with type 2 diabetes mellitus (T2DM). Prevalence of DR remained stable in people with T2DM and decreased in people with T1DM. Screening for DR increased over time for patients with T2DM and remained static for patients with T1DM Incidence of DR increased in parallel with the incidence of T2DM in both diabetic populations. Among patients with T2DM, relative risk of DR varied significantly by region, was increased for older age groups and in men compared with women, with risk of severe DR increased in South Asian groups and more deprived groups. Relative risk of DR for patients with T1DM varied by age and region, but not by gender, ethnic group or deprivation.Conclusions: This is the largest study to date examining the burden of DR in the UK. Regional disparities in incidence may relate to differences in screening delivery and disease ascertainment. Evidence that deprivation and ethnicity are associated with a higher risk of severe DR highlights a significant potential health inequality. Findings from this study will have implications for professionals working in the diabetes and sight loss sectors, particularly to inform approaches for diagnosis of retinopathy and campaigning to better tackle the disease for at risk groups.