无视网膜病变的2型糖尿病患者的纵向神经和微血管变化:一项2年前瞻性队列研究

IF 4.2 1区 医学 Q1 OPHTHALMOLOGY
Yiran Fan,Lingyi Li,Xinyan Wu,Yayi Yan,Pan Li,Likun Lin,Yuntong Li,Ching-Kit Tsui,Kaiqun Liu,Wenyong Huang,Xiaoling Liang,Andina Hu,
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引用次数: 0

摘要

目的比较无视网膜病变(non-DR) 2型糖尿病(T2DM)患者黄斑神经节细胞-内丛状层厚度(GCIPLT)和浅毛细血管丛(SCP)血管密度2年纵向变化。前瞻性观察队列研究。方法从广州社区招募基线时无临床视网膜病变的st2dm患者和年龄、性别匹配的健康对照组,随访2年。在基线和2年随访时测量黄斑GCIPLT、视网膜厚度(RT)和SCP血管密度。线性混合效应模型用于估计绝对变化率和相对变化率,并比较两组之间的绝对变化率。结果共纳入282只眼(对照组141只,非dr组141只)。GCIPT和GCIPLT/RT的显著降低仅发生在非dr组,GCIPLT下降了-0.229 μm/年(95%可信区间[CI]: -0.313至-0.144;P < 0.001)和0.324% (95%CI: 0.444至0.204;P < 0.001),大约比对照组快5倍。在调整混杂因素后,与对照组相比,非dr组的RT、GCIPLT和GCIPLT/RT的纵向率分别显著加快-0.603 μm/年(95% CI: -0.939 ~ -0.268; P < 0.001)、-0.189 μm/年(95% CI: -0.306 ~ -0.073; P = 0.001)和- 0.073% (95% CI: -0.118 ~ -0.028; P = 0.001)。而两组间SCP血管密度的纵向变化差异无统计学意义(P = 0.861)。结论:我们的研究结果表明,非dr患者的神经退行性改变可能先于微血管改变,这表明监测GCIPLT对于长期患有糖尿病的患者至关重要,即使没有视网膜病变。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Longitudinal neural and microvascular changes in type 2 diabetic patients without retinopathy: a 2-year prospective cohort study.
PURPOSE To compare the 2-year longitudinal changes in macular ganglion cell-inner plexiform layer thickness (GCIPLT) and superficial capillary plexus (SCP) vessel density between patients with type 2 diabetes mellitus (T2DM) without retinopathy (non-DR) and healthy controls. DESIGN Prospective observational cohort study. METHODS T2DM patients without clinical retinopathy at baseline and after a 2-year follow-up, along with age- and sex-matched healthy controls, were recruited from the community in Guangzhou. Measurements of macular GCIPLT, retinal thickness (RT), and SCP vessel density were conducted at baseline and at the 2-year follow-up. Linear mixed-effects models were used to estimate absolute and relative rates of changes and to compare absolute rates between the two groups. RESULTS A total of 282 eyes (141 in the control group and 141 in the non-DR group) were included in the analysis. Significant reductions in GCIPT and GCIPLT/RT occurred only in the non-DR group, with GCIPLT decreasing by -0.229 μm/year (95% confidence interval [CI]: -0.313 to -0.144; P < 0.001) and 0.324 % (95%CI: 0.444 to 0.204; P < 0.001), approximately 5-fold faster than the control group. After adjusting for confounding factors, the longitudinal rates of RT, GCIPLT, and GCIPLT/RT were significantly accelerated in the non-DR group compared to the control group by -0.603 μm/year (95% CI: -0.939 to -0.268; P < 0.001), -0.189 μm/year (95% CI: -0.306 to -0.073; P = 0.001), and -0.073 % (95% CI: -0.118 to -0.028; P = 0.001), respectively. While, longitudinal changes in SCP vessel density did not show significant differences between the two groups (P = 0.861). CONCLUSIONS Our findings suggest that neurodegenerative changes may precede microvascular alterations in non-DR patients, indicating that monitoring of GCIPLT is crucial for patients with long-standing diabetes, even in the absence of retinopathy.
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来源期刊
CiteScore
9.20
自引率
7.10%
发文量
406
审稿时长
36 days
期刊介绍: The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect. The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports. Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.
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