Epidemiology of Diabetic Retinopathy

糖尿病视网膜病变的流行病学

• 批准号: 7112252
• 负责人: RONALD KLEIN
• 金额: $ 82.21万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-01 至 2009-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7112252
• 关键词: acute phase protein; amputation; biomarker; blood pressure; cell adhesion; clinical research; depression; diabetes mellitus; diabetic retinopathy; edema; epidemiology; eye fundus photography; human subject; inflammation; insulin sensitivity /resistance; interleukin 6; intraocular pressure; limbs; longitudinal human study; medical complication; myocardial infarction; patient oriented research; quality of life; questionnaires; retina disorder; tumor necrosis factor alpha; vision disorders; vision tests

DESCRIPTION (provided by applicant): This epidemiological study aims to: (1) determine the cumulative 15-year progression of diabetic retinopathy and incidence of proliferative retinopathy, macular edema, visual impairment, other microvascular (diabetic nephropathy) and macrovascular (myocardial infarction, lower extremity amputation) complications in persons with type I diabetes and quantify the risk of these outcomes with regard to markers of inflammation, endothelial dysfunction, cellular adhesion and of estimated insulin resistance; (2) examine the association of change in visual acuity and changes in self-rated health and self-reported visual-targeted quality of life in type 1 persons with long term diabetes over a ten year period; and (3) examine the cross-sectional association of visual impairment and depression in persons with type 1 diabetes. The study builds upon the population-based Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR, NEIR01 03083) which included all insulin-taking persons with type 1 diabetes and who were receiving primary medical care in an 11-county area of southwestern Wisconsin in 1979-1980. Exams were performed in 1980-82, 1984-86, 1990-92, 1995-96, and 2000-01. These persons will be examined in their communities in a mobile examining van. Refraction, visual acuity, intraocular pressure, blood pressure and other measurements will be obtained according to standardized protocols. Objective recording of retinopathy from stereoscopic fundus photography combined with a standardized grading will be used. Standardized questionnaires including the SF-36, the NEI-VFQ 25, and the Center for Epidemiologic Studies Depression Scale (CES-D) will be administered. C-reactive protein, interleukin-6, tumor necrosis factor-"c, and other markers of inflammation, endothelial dysfunction, and cellular adhesion will be measured. New data from this study will provide a unique opportunity to evaluate the relationship of new factors to the presence and severity of retinopathy and to the progression of retinopathy and incidence of other micro- vascular (e.g., diabetic nephropathy) and macrovascular (e.g., lower extremity amputation, myocardial infarction) complications and will provide needed information regarding the associations of retinopathy and visual impairment to self-reported visual-targeted quality of life and depression in persons with long duration of type 1 diabetes. These data will be useful to patients and their physicians involved in the management of diabetes and to public health practitioners designing and delivering preventive care services. Conversely, the new data to be collected in this study may provide insights into the relative protective value of low levels of markers of inflammatory, cell adhesion, and endothelial dysfunction on vascular complications of diabetes mellitus.

描述（由申请人提供）：本流行病学研究旨在：(1) 确定 I 型糖尿病患者糖尿病视网膜病变 15 年累积进展情况以及增殖性视网膜病变、黄斑水肿、视力障碍、其他微血管（糖尿病肾病）和大血管（心肌梗死、下肢截肢）并发症的发生率，并量化 这些结果与炎症、内皮功能障碍、细胞粘附和估计的胰岛素抵抗标志物有关的风险； (2) 检查 10 年内患有长期糖尿病的 1 型患者的视力变化与自评健康和自我报告的视觉目标生活质量变化之间的关联； (3) 检查 1 型糖尿病患者视力障碍和抑郁症的横断面关联。该研究以威斯康星州糖尿病视网膜病变流行病学研究（WESDR，NEIR01 03083）为基础，该研究包括 1979 年至 1980 年威斯康星州西南部 11 个县地区所有服用胰岛素的 1 型糖尿病患者并接受初级医疗护理。考试于1980-82年、1984-86年、1990-92年、1995-96年和2000-01年进行。 这些人将在其社区内使用移动检查车接受检查。屈光度、视力、眼压、血压和其他测量值将根据标准化协议获得。将使用立体眼底摄影结合标准化分级客观记录视网膜病变。将使用标准化问卷，包括 SF-36、NEI-VFQ 25 和流行病学研究中心抑郁量表 (CES-D)。将测量 C 反应蛋白、白细胞介素 6、肿瘤坏死因子-c 以及其他炎症、内皮功能障碍和细胞粘附的标志物。 这项研究的新数据将提供一个独特的机会来评估新因素与视网膜病变的存在和严重程度以及视网膜病变的进展以及其他微血管（例如糖尿病肾病）和大血管（例如下肢截肢、心肌梗塞）并发症的发生率之间的关系，并将提供有关视网膜病变和视力障碍与视网膜病变之间关系的所需信息。 长期 1 型糖尿病患者自我报告的视觉目标生活质量和抑郁情况。这些数据将对参与糖尿病管理的患者及其医生以及设计和提供预防保健服务的公共卫生从业者有用。相反，本研究收集的新数据可能有助于了解低水平炎症、细胞粘附和内皮功能障碍标志物对糖尿病血管并发症的相对保护价值。