Association of Diabetic Retinopathy With Stroke: A Systematic Review and Meta-Analysis.
Association of Diabetic Retinopathy With Stroke: A Systematic Review and Meta-Analysis.
复制标题
DOI：
10.3389/fneur.2021.626996
复制
发表时间：
2021
影响因子：
3.4
通讯作者：
Ma B
中科院分区：
文献类型：
--
作者：
Hu K;Jiang M;Zhou Q;Zeng W;Lan X;Gao Q;Mei F;Zhao L;Chen F;Wu A;Tao G;Mou C;Ma B
背景：迄今为止进行的基于人群的研究并未提供糖尿病视网膜病变（DR）与中风之间联系的确凿证据。本系统综述的目的是确定DR是否与中风有特别的关系。方法：系统检索MEDLINE、Embase和Web of Science自建站至2020年7月31日的数据库。所有报道DR存在与偶发性卒中之间关联的队列研究均被纳入。计算合并风险比（hr）、合并风险比（RRs）和95%置信区间（ci）。结果：meta分析纳入19项队列研究，涉及81452例糖尿病患者。任何与卒中相关的DR的合并效应大小为HR 1.25 (95% CI: 1.12-1.39; P < 0.0001), RR 1.96 （95% CI: 1.60-2.39; P < 0.0001）。糖尿病类型的亚组分析显示，2型糖尿病（T2DM）患者的总风险比为1.29 （95% CI: 1.10-1.50; P = 0.001）。T2DM患者的合并RR为2.29 （95% CI: 1.77-2.96; P < 0.0001）。两项研究探讨了1型糖尿病（T1DM）患者的dr相关性卒中。一项研究发现DR和卒中之间存在显著关联（OR: 1.6; 95% CI: 1.1-2.3; P < 0.01），而另一项研究没有发现这两种情况之间存在关联（RR: 1.40; 95% CI: 0.62-2.18; P = 0.178）。结论：DR的存在与糖尿病患者卒中风险增加有关。这种相关性在T2DM患者中很明显，但在T1DM患者中不确定。我们的研究结果表明，DR是预测中风的重要生物标志物。为了进一步验证DR在卒中风险分层中的作用，需要进一步研究DR分期与卒中风险之间的关系，需要更多包括T1DM患者在内的研究。
Background: The population-based studies conducted thus far do not provide conclusive evidence of the link between diabetic retinopathy (DR) and stroke. The aim of the present systematic review was to determine whether DR is specifically associated with stroke. Methods: MEDLINE, Embase, and Web of Science were systematically searched from their inception to July 31, 2020. All cohort studies that reported associations between the presence of DR and incident stroke were included. The pooled hazard ratios (HRs), pooled risk ratios (RRs), and 95% confidence intervals (CIs) were calculated. Results: The meta-analysis included 19 cohort studies involving 81,452 diabetic patients. The pooled effect size of any DR related to stroke was 1.25 for HR (95% CI: 1.12–1.39; P < 0.0001) and 1.96 for RR (95% CI: 1.60–2.39; P < 0.0001). Subgroup analysis for the type of diabetes yielded pooled HR of 1.29 (95% CI: 1.10–1.50; P = 0.001) in patients with type 2 diabetes mellitus (T2DM). The pooled RR was 2.29 (95% CI: 1.77–2.96; P < 0.0001) in patients with T2DM. Two studies addressed the DR-related stroke among type 1 diabetes mellitus (T1DM) patients. One study found a significant association between DR and stroke (OR: 1.6; 95% CI: 1.1–2.3; P < 0.01), while the other did not identify an association between these two conditions (RR: 1.40; 95% CI: 0.62–2.18; P = 0.178). Conclusions: The presence of DR is associated with an increased risk of stroke in diabetic patients. This correlation is robust in T2DM patients but uncertain in T1DM patients. Our findings indicate that DR is an important biomarker for the prediction of stroke. To further validate the role of DR in stroke-risk stratification, additional research is required on the association between the stage of DR and stroke risk, and more studies including T1DM patients are necessary.
登录
查看更多内容
协议试验中的糖尿病性视网膜病，其进展和入射心血管事件。
影响因子：
16.2
作者：
Gerstein HC;Ambrosius WT;Danis R;Ismail-Beigi F;Cushman W;Calles J;Banerji M;Schubart U;Chew EY;ACCORD Study Group
通讯作者：
ACCORD Study Group
影响因子：
13.6
作者：
Leppälä, JM;Virtamo, J;Heinonen, OP
通讯作者：
Heinonen, OP
影响因子：
8
作者：
Bergman, Michael;Jagannathan, Ram;Dankner, Rachel
通讯作者：
Dankner, Rachel
影响因子：
8.3
作者：
Cheung, Ning;Rogers, Sophie;Wong, Tien Y.
通讯作者：
Wong, Tien Y.
影响因子：
105.7
作者：
Higgins, JPT;Thompson, SG;Altman, DG
通讯作者：
Altman, DG