Study on Risk Factors Associated with Severity of Diabetic Retinopathy in Type-2 Diabetic Patients, Attending a Tertiary Care Centre in Kerala

Q4 Health Professions
Nandini Varma, Sinumol Thulaseedharan
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Abstract

Introduction: Diabetic retinopathy (DR) is a significant public health concern affecting individuals with diabetes mellitus (DM). Despite treatment advances, a substantial proportion of patients do not respond adequately. This study investigates risk factors associated with the progression of non-proliferative diabetic retinopathy (NPDR) to proliferative diabetic retinopathy (PDR) in type-2 diabetes patients. Methods: A retrospective case-control study was conducted on diabetic patients older than 40 years with at least 5 years of Type-2 Diabetes Mellitus history, attending ophthalmology clinic in Government Medical College, Thrissur, a tertiary care hospital. Data from patients with retinal examination showing diabetic retinopathy were analyzed. Records with missing data were excluded. Patients with Proliferative Diabetic Retinopathy (n=153) were compared with those having Non- Proliferative Diabetic Retinopathy (n=230). Various risk factors were assessed using statistical analysis. Results: Among the studied variables, sex, duration of diabetes, serum urea, serum creatinine, serum triglycerides, and chronic kidney disease were significantly different between Proliferative Diabetic Retinopathy and Non-Proliferative Diabetic Retinopathy patients. Binary logistic regression revealed that duration of diabetes (OR = 1.8, 95% CI = 1.1 - 2.39) and serum creatinine (OR =1.8, 95% CI = 1.1 - 2.39) independently influenced Proliferative Diabetic Retinopathy development. Conclusion: This study highlights that longer diabetes duration and elevated serum creatinine levels independently increase the risk of Non- Proliferative Diabetic Retinopathy progressing to Proliferative Diabetic Retinopathy in type-2 diabetic patients. Other factors such as age, gender, hyperlipidemia, systemic hypertension, type of diabetic treatment, and history of ischemic heart disease did not show significant associations with disease progression. These findings emphasize the importance of close monitoring, early detection, and intervention in patients with Non- Proliferative Diabetic Retinopathy, particularly those with a longer diabetic history, to prevent Proliferative Diabetic Retinopathy development. Further research should explore the causal relationship between serum creatinine and diabetic retinopathy progression and evaluate the impact of renal disease management on disease outcomes. Keywords: Diabetic Retinopathy, diabetes mellitus (DM), Type-2 Diabetes Mellitus (T2DM).
喀拉拉邦三级保健中心2型糖尿病患者糖尿病视网膜病变严重程度相关危险因素研究
糖尿病视网膜病变(DR)是影响糖尿病(DM)患者的重大公共卫生问题。尽管治疗取得了进展,但相当大比例的患者没有充分的反应。本研究探讨了2型糖尿病患者非增殖性糖尿病视网膜病变(NPDR)向增殖性糖尿病视网膜病变(PDR)发展的相关危险因素。方法:采用回顾性病例对照研究,选取在三级医院特里苏瑟政府医学院眼科门诊就诊的年龄大于40岁且有5年以上2型糖尿病病史的糖尿病患者。分析了糖尿病视网膜病变患者的视网膜检查数据。数据缺失的记录被排除。153例增殖性糖尿病视网膜病变患者与230例非增殖性糖尿病视网膜病变患者进行比较。采用统计学方法对各种危险因素进行评估。结果:在研究变量中,性别、糖尿病病程、血清尿素、血清肌酐、血清甘油三酯、慢性肾脏疾病在增殖性糖尿病视网膜病变与非增殖性糖尿病视网膜病变患者之间存在显著差异。二元logistic回归显示,糖尿病病程(OR =1.8, 95% CI = 1.1 - 2.39)和血清肌酐(OR =1.8, 95% CI = 1.1 - 2.39)独立影响增生性糖尿病视网膜病变的发展。结论:本研究强调2型糖尿病患者糖尿病病程延长和血清肌酐水平升高可独立增加非增殖性糖尿病视网膜病变发展为增殖性糖尿病视网膜病变的风险。其他因素如年龄、性别、高脂血症、全身性高血压、糖尿病治疗类型和缺血性心脏病史与疾病进展无显著相关性。这些发现强调了密切监测、早期发现和干预非增殖性糖尿病视网膜病变患者的重要性,特别是那些有较长糖尿病病史的患者,以防止增殖性糖尿病视网膜病变的发展。进一步的研究应探讨血清肌酐与糖尿病视网膜病变进展之间的因果关系,并评估肾脏疾病管理对疾病结局的影响。关键词:糖尿病视网膜病变,糖尿病,2型糖尿病
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来源期刊
International Journal of Current Research and Review
International Journal of Current Research and Review Health Professions-Health Professions (miscellaneous)
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162
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