UKPDS 50: Risk factors for incidence and progression of retinopathy in Type II diabetes over 6 years from diagnosis
UKPDS 50: Risk factors for incidence and progression of retinopathy in Type II diabetes over 6 years from diagnosis
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DOI：
10.1007/s001250051594
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发表时间：
2001-02-01
期刊：
影响因子：
8.2
通讯作者：
Matthews, DR
中科院分区：
文献类型：
--
作者：
Stratton, IM;Kohner, EM;Matthews, DR
目的/假设。确定与诊断为II型（非胰岛素依赖型）糖尿病后6年内糖尿病视网膜病变发病率和进展相关的危险因素。本报告描述了来自英国前瞻性糖尿病研究（UKPDS）的1919例患者，在诊断时和6年后拍摄了视网膜照片，并提供了完整的数据。使用改良的糖尿病视网膜病变早期治疗研究最终量表对照片进行糖尿病视网膜病变的集中分级。从糖尿病诊断之日起3个月后对风险因素进行评估。患者每3个月在医院就诊一次。由中心实验室进行生化测量。玻璃体出血和光凝的终点由系统收集的临床数据的独立裁定证实。主要的结果指标是视网膜病变的发生率和进展，视网膜病变定义为糖尿病视网膜病变早期治疗研究（ETDRS）的两步最终量表变化。在1919例患者中，1216例（63%）在诊断时无视网膜病变。到6年时，其中22%的人患上了视网膜病变，即双眼的微动脉瘤或更糟。在703例（37%）诊断为视网膜病变的患者中，29%的患者进展了两个或更多的量表。视网膜病变的发生（发病率）与基线高血压、6年以上高血压暴露、高血压和不吸烟密切相关。在那些已经有视网膜病变的患者中，进展与年龄较大、男性、高血糖（如HbA（1c）较高）和不吸烟有关。研究结果再次强调，如果要将糖尿病视网膜病变降至最低，则需要良好的血糖控制和对高血压的勤奋治疗。
Aims/hypothesis. To determine risk factors related to the incidence and progression of diabetic retinopathy over 6 years from diagnosis of Type II (non-insulin-dependent) diabetes mellitus.Methods. This report describes 1919 patients from within the United Kingdom Prospective Diabetes Study (UKPDS), with retinal photographs taken at diagnosis and 6 years later and with complete data available. Photographs were centrally graded for lesions of diabetic retinopathy using the modified Early Treatment of Diabetic Retinopathy Study Final scale. Risk factors were assessed after 3 months diet from the time of diagnosis of diabetes. Patients were seen every 3 months in a hospital setting. Biochemical measurements were done by a central laboratory. End points of vitreous haemorrhage and photocagulation were confirmed by independent adjudication of systematically collected clinical data. The main outcome measures were incidence and progression of retinopathy defined as a two-step Early Treatment of Diabetic Retinopathy Study (ETDRS) final scale change.Results. Of the 1919 patients, 1216 (63%) had no retinopathy at diagnosis. By 6 years, 22% of these had developed retinopathy, that is microaneurysms in both eyes or worse. In the 703 (37%) patients with retinopathy at diagnosis, 29% progressed by two scale steps or more. Development of retinopathy (incidence) was strongly associated with baseline glycaemia, glycaemic exposure over 6 years, higher blood pressure and with not smoking. In those who already had retinopathy, progression was associated with older age, male sex, hyperglycaemia las evidenced by a higher HbA(1c)) and with not smoking.Conclusion/interpretation. The findings re-emphasise the need for good glycaemic control and assiduous treatment of hypertension if diabetic retinopathy is to be minimised.