慢性肾脏疾病与糖尿病视网膜和脉络膜血管密度的线性和非线性关系：一项前瞻性研究。

IF 3.1 3区医学 Q2 ONCOLOGY

Photodiagnosis and Photodynamic Therapy Pub Date : 2025-05-08 DOI:10.1016/j.pdpdt.2025.104625

Lijian Fang , Ruiheng Zhang , Suoqing Zhuang , Lei Wang , Qiuping Wang , Yong Huang , Mingli Wang , Yu Feng , Min Xiao , Chunyuan Zhou , Lili Wu , Sihan Zhang , Lili Xue , Tong Tian , Yuanyuan Li , Bing Cao , Huaiyu Hao

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引用次数: 0

摘要

目的：利用光学相干断层血管造影（OCTA）研究视网膜和脉络膜血管密度与肾功能的关系。方法：前瞻性招募2023年10月至2024年3月在北京良乡医院住院的连续糖尿病患者。所有参与者在第一次就诊时进行了全面的眼科检查和实验室分析。OCTA扫描的定量参数包括视网膜浅血管复合体（SVC）和深血管复合体（DVC）血管密度，绒毛膜毛细血管血流缺陷（CCFD%）。结果：本研究共纳入85例患者。在调整糖尿病视网膜病变的严重程度和其他混杂因素后，ETDRS网格内SVC每增加1%，CKD发病率降低（OR=0.86 95%CI:[0.73-1.01]），尿白蛋白与肌酐比值降低（ACR，系数=-0.65,95%CI:[-1.22, -0.08]）， eGFR升高（系数=1.55,95%CI:[0.14, 2.96]）。CCFD每增加1%，CKD发病率增加（OR=1.72, 95%CI:[1.14-2.58]）和eGFR降低（系数=-6.47,95%CI:[-9.68, -3.26]）显著相关。非线性回归显示晚期视网膜微血管损伤患者SVC血管密度与eGFR相关。结论：视网膜和脉络膜血流与慢性肾病的发病和严重程度有关。降低的SVC和降低的CCFD%可用于糖尿病患者CKD的无创筛查。

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Linear and non-linear association of chronic kidney disease with retina and choroid vessel density in diabetes: a prospective study

Purpose

To investigate the association of retinal and choroidal vessel density with renal function using optical coherence tomographic angiography (OCTA).

Method

The present study prospectively recruited consecutive diabetes patients admitted to Beijing Liangxiang Hospital from October 2023 to March 2024. All participants underwent comprehensive ophthalmologic examinations and laboratory analysis at the first visit. Quantitative parameters of OCTA scans included retinal superficial vascular complex (SVC) and deep vascular complex (DVC) vessel densities, and choriocapillaris flow deficits (CCFD%).

Results

A total of 85 patients were included in the present study. After adjusting for severity of diabetic retinopathy and other confounding factors, every 1 % increased SVC within in ETDRS grid was associated with reduced incidence of CKD (OR=0.86 95 %CI:[0.73–1.01]), decreased urine albumin-to-creatinine ratio (ACR, coefficient=-0.65, 95 %CI:[-1.22, -0.08]), and increased eGFR (coefficient=1.55, 95 %CI:[0.14, 2.96]). Every 1 % increased CCFD% was significantly associated with increased incidence of CKD (OR=1.72, 95 %CI:[1.14–2.58]) and decrease eGFR (coefficient=-6.47, 95 %CI:[-9.68, -3.26]). Non-linear regression revealed that SVC vessel density was associated with eGFR among patients with advanced retinal microvasculature damage.

Conclusions

Retina and choroid blood flow were associated with the onset and severity of CKD. Decreased SVC and decreased CCFD% can be used for non-invasively screening CKD in diabetes patients.

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来源期刊

Photodiagnosis and Photodynamic Therapy ONCOLOGY-

CiteScore

5.80

自引率

24.20%

发文量

509

审稿时长

50 days

期刊介绍： Photodiagnosis and Photodynamic Therapy is an international journal for the dissemination of scientific knowledge and clinical developments of Photodiagnosis and Photodynamic Therapy in all medical specialties. The journal publishes original articles, review articles, case presentations, "how-to-do-it" articles, Letters to the Editor, short communications and relevant images with short descriptions. All submitted material is subject to a strict peer-review process.