The association between age at diagnosis of diabetes and development of diabetic retinopathy and assessment of healthcare access as an effect modifier.

IF 2.9 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications Pub Date : 2024-12-05 DOI:10.1016/j.jdiacomp.2024.108931

Bria L George, Alejandro M Perez, Pura Rodriguez, Prashant Parekh, Noël C Barengo

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引用次数: 0

Abstract

Aims: To examine if healthcare access modifies the association between age at diagnosis of diabetes and the prevalence of retinopathy.

Methods: BRFSS 2020 survey data was obtained from 12,198 adults. Participants with missing information in the variables "retinopathy" (N = 569) and "insurance-cost barrier" (N = 75) were excluded. The final sample included 11,556 participants. Age at diagnosis of diabetes was the main exposure and retinopathy was the main outcome. We tested if the main association was different among the insurance-cost barrier variable. Binary logistic regression models were used to calculate odds ratios (OR) and 95 % confidence intervals (CI).

Results: The odds of retinopathy decreased by 22 % in patients 46-64 years-of-age (OR 0.78; 95 CI 0.6-1.0) and 57 % in those 65+ (OR 0.43; 95 CI 0.28-0.65). The odds decreased by 39 % if female (OR 0.61; 95 CI 0.48-0.77). An increase in odds by 86 % (OR 1.86; 95 CI 1.07-3.21) occurred in other non-Hispanics, 50 % (OR 1.50; 95 CI 1.13-1.99) in black non-Hispanics and 70 % (OR 1.70; 95 CI 1.17-2.46) in Hispanics. There was no evidence that age at diagnosis of diabetes and presence of retinopathy varied by insurance cost (p > 0.05).

Conclusion: Health professionals may utilize these results to advocate for early disease intervention.

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糖尿病诊断年龄与糖尿病视网膜病变发展之间的关系以及医疗保健可及性评估作为影响调节因子。

目的：研究医疗服务是否会改变糖尿病确诊年龄与视网膜病变患病率之间的关系：BRFSS 2020 调查数据来自 12,198 名成年人。排除了 "视网膜病变 "变量（569 人）和 "保险费用障碍 "变量（75 人）信息缺失的参与者。最终样本包括 11556 名参与者。糖尿病确诊年龄是主要暴露因素，视网膜病变是主要结果。我们测试了保险费用障碍变量之间的主要关联是否不同。我们使用二元逻辑回归模型计算了几率比（OR）和 95 % 的置信区间（CI）：46-64岁患者发生视网膜病变的几率降低了22%（OR为0.78；95 CI为0.6-1.0），65岁以上患者发生视网膜病变的几率降低了57%（OR为0.43；95 CI为0.28-0.65）。如果是女性，几率会降低 39%（OR 0.61；95 CI 0.48-0.77）。其他非西班牙裔美国人的几率增加了 86%（OR 1.86；95 CI 1.07-3.21），非西班牙裔黑人的几率增加了 50%（OR 1.50；95 CI 1.13-1.99），西班牙裔美国人的几率增加了 70%（OR 1.70；95 CI 1.17-2.46）。没有证据表明糖尿病确诊年龄和视网膜病变的存在因保险费用而异（P > 0.05）：结论：医疗专业人员可利用这些结果倡导早期疾病干预。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of diabetes and its complications 医学-内分泌学与代谢

CiteScore

5.90

自引率

3.30%

发文量

153

审稿时长

16 days

期刊介绍： Journal of Diabetes and Its Complications (JDC) is a journal for health care practitioners and researchers, that publishes original research about the pathogenesis, diagnosis and management of diabetes mellitus and its complications. JDC also publishes articles on physiological and molecular aspects of glucose homeostasis. The primary purpose of JDC is to act as a source of information usable by diabetes practitioners and researchers to increase their knowledge about mechanisms of diabetes and complications development, and promote better management of people with diabetes who are at risk for those complications. Manuscripts submitted to JDC can report any aspect of basic, translational or clinical research as well as epidemiology. Topics can range broadly from early prediabetes to late-stage complicated diabetes. Topics relevant to basic/translational reports include pancreatic islet dysfunction and insulin resistance, altered adipose tissue function in diabetes, altered neuronal control of glucose homeostasis and mechanisms of drug action. Topics relevant to diabetic complications include diabetic retinopathy, neuropathy and nephropathy; peripheral vascular disease and coronary heart disease; gastrointestinal disorders, renal failure and impotence; and hypertension and hyperlipidemia.