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首页> 外文期刊>Diabetes care >Risk Factors for Retinopathy in Type 1 Diabetes: The DCCT/EDIC Study
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Risk Factors for Retinopathy in Type 1 Diabetes: The DCCT/EDIC Study

机译：1型糖尿病患者视网膜病变的危险因素：DCCT / edic研究

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OBJECTIVE The Diabetes Control and Complications Trial (DCCT) demonstrated that intensive therapy reduced the development and progression of retinopathy in type 1 diabetes (T1D) compared with conventional therapy. The Epidemiology of Diabetes Interventions and Complications (EDIC) study observational follow-up showed persistent benefits. In addition to glycemia, we now examine other potential retinopathy risk factors (modifiable and nonmodifiable) over more than 30 years of follow-up in DCCT/EDIC. RESEARCH DESIGN AND METHODS The retinopathy outcomes were proliferative diabetic retinopathy (PDR), clinically significant macular edema (CSME), and ocular surgery. The survival (event-free) probability was estimated using the Kaplan-Meier method. Cox proportional hazards models assessed the association between risk factors and subsequent risk of retinopathy. Both forward- and backward-selection approaches determined the multivariable models. RESULTS Rate of ocular events per 1,000 person-years was 12 for PDR, 14.5 for CSME, and 7.6 for ocular surgeries. Approximately 65%, 60%, and 70% of participants remained free of PDR, CSME, and ocular surgery, respectively. The greatest risk factors for PDR in descending order were higher mean HbA(1c), longer duration of T1D, elevated albumin excretion rate (AER), and higher mean diastolic blood pressure (DBP). For CSME, risk factors, in descending order, were higher mean HbA(1c), longer duration of T1D, and greater age and DBP and, for ocular surgeries, were higher mean HbA(1c), older age, and longer duration of T1D. CONCLUSIONS Mean HbA(1c) was the strongest risk factor for the progression of retinopathy. Although glycemic control is important, elevated AER and DBP were other modifiable risk factors associated with the progression of retinopathy.
机译：目的糖尿病控制和并发症试验（DCCT）证明，与常规治疗相比，强化治疗减少了1型糖尿病（T1D）中视网膜病变的开发和进展。糖尿病干预和并发症的流行病学（edic）研究观察随访显示出持续的益处。除糖肿瘤外，我们现在还在DCCT / edic中的30多年后续30多年后检查其他潜在的视网膜病危险因素（可修改和不可替代）。研究设计和方法视网膜病变结果是增殖性糖尿病视网膜病变（PDR），临床上显着的黄斑水肿（CSME）和眼科手术。使用Kaplan-Meier方法估算生存（无事件）概率。 Cox比例危险模型评估了风险因素与随后视网膜病的关联。双重和后向选择方法都确定了多变量模型。结果每1000人的眼部事件率为12例为12例，14.5，用于CSME，7.6个眼镜手术。大约65％，60％和70％的参与者分别保持不含PDR，CSME和眼科手术。下降秩序中PDR的最大风险因素较高平均HBA（1C），T1D较长持续时间，升高的白蛋白排泄率（AER），以及更高的平均舒张压（DBP）。对于CSME，危险因素以降序为更高的平均HBA（1C），T1D的持续时间越长，更大的年龄和DBP以及眼镜手术的平均值高（1C），年龄较大，更长的T1D持续时间。结论平均HBA（1C）是视网膜病变进展的最强烈的危险因素。虽然血糖控制很重要，但升高的AER和DBP是与视网膜病变的进展相关的其他可修饰的危险因素。

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