血糖状况与年龄相关性黄斑变性的相关性:一项全国性的基于人群的队列研究

IF 4.6 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Hyungwoo Lee , Kyung-Do Han , Jinyoung Shin
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引用次数: 0

摘要

目的根据2型糖尿病的空腹血糖水平和病程,探讨干、湿性年龄相关性黄斑变性(AMD)的风险。方法利用健康保险索赔数据库和韩国的健康检查结果,我们对2103604名年龄≥45岁的无AMD的成年人进行了一项基于人群的回顾性队列研究,这些成年人是根据2009年的健康检查进行的,观察时间为2011年1月1日至2018年12月31日。血糖状态分为五组:正常、空腹血糖受损、新发糖尿病(空腹血糖水平≥126mg/dl,但没有糖尿病诊断或糖尿病药物)、糖尿病诊断<;5年,糖尿病≥5年。根据脉络膜新生血管的存在和不存在,AMD分别分为湿性AMD和干性AMD。在每一个类别中估计AMD发生的调整后的危险比(HR)。结果对于干性AMD(n=36271,1.72%),糖尿病<;在调整了年龄、性别、体重指数、生活方式和病史后,糖尿病≥5岁的受试者与血糖正常的受试对象相比,5岁和1.294(1.242-1.349)。对于湿性AMD(n=12912,0.61%),新发糖尿病受试者的HR为1.103(1.011–1.203),糖尿病<;糖尿病≥5岁的受试者为1.506(1.413-1.605)。在≤65岁的参与者和没有高血压的参与者中,AMD的HR显著增加。结论与血糖正常组相比,糖尿病患者中干型和湿型AMD的发生率增加。当糖尿病持续时间为5年或5年以上时,这些风险会增加。新发糖尿病患者患湿性AMD的风险增加。这些结果表明,未经治疗的高血糖水平可能会导致湿性AMD的视力威胁,强调了早期血糖管理的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Association between glycemic status and age-related macular degeneration: A nationwide population-based cohort study

Aim

The risk of dry and wet age-related macular degeneration (AMD) based on fasting glucose levels and disease duration of type 2 diabetes was investigated.

Methods

Using a health insurance claims database and the results of health examinations in South Korea, we conducted a retrospective, population-based cohort study of 2,103,604 adults ≥ 45 years of age who were AMD-free based on health checkups in 2009 and observed from January 1, 2011, to December 31, 2018. Glycemic status was classified into five groups: normal, impaired fasting glucose, new-onset diabetes (fasting glucose level ≥ 126 mg/dl but no diabetes diagnosis or diabetes medication), diabetes diagnosis < 5 years, and diabetes ≥ 5 years. According to the presence and absence of choroidal neovascularization, AMD was classified as wet AMD and dry AMD, respectively. Adjusted hazard ratios (HRs) of AMD occurrence were estimated in each category.

Results

For dry AMD (n = 36,271, 1.72%), the HR was 1.192 (1.141–1.245) among subjects with diabetes < 5 years and 1.294 (1.242–1.349) among subjects with diabetes ≥ 5 years compared with subjects with normal glycemic status after adjusting for age, sex, body mass index, lifestyle, and medical history. For wet AMD (n = 12,912, 0.61%), the HR was 1.103 (1.011–1.203) among subjects with new-onset diabetes, 1.252 (1.167–1.344) among subjects with diabetes < 5 years, and 1.506 (1.413–1.605) among subjects with diabetes ≥ 5 years. The HR of AMD was significantly increased among participants ≤ 65 years old and those who did not have hypertension.

Conclusions

The incidence of dry and wet AMD increased among diabetes patients compared to the normal glycemic status group. These risks increased when the duration of diabetes was 5 years or more. The risk of wet AMD was increased among new-onset diabetes patients. These results suggest that high blood glucose levels without treatment might induce the vision-threatening condition of wet AMD, emphasizing the importance of early blood glucose management.

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来源期刊
Diabetes & metabolism
Diabetes & metabolism 医学-内分泌学与代谢
CiteScore
12.00
自引率
4.20%
发文量
86
审稿时长
13 days
期刊介绍: A high quality scientific journal with an international readership Official publication of the SFD, Diabetes & Metabolism, publishes high-quality papers by leading teams, forming a close link between hospital and research units. Diabetes & Metabolism is published in English language and is indexed in all major databases with its impact factor constantly progressing. Diabetes & Metabolism contains original articles, short reports and comprehensive reviews.
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