Relationship between glomerular filtration rate and diabetic retinopathy in type 2 diabetic patients / 中华眼底病杂志

ABSTRACT

Objective To investigate the relationship between glomerular filtration rate (GFR) and diabetic retinopathy (DR) and macular thickness in patients with type 2 diabetes mellitus (T2DM).Methods A total of 161 T2DM inpatients were enrolled in this study.There were 95 males (95 eyes) and 66 females (66 eyes),with an average age of (62.2±11.0) years.The average duration of diabetes was (14.8±7.9) years.The patients were grouped according to the degree of DR.Among them,91 patients were no DR,24 patients were mild non-proliferative DR (NPDR),24 patients were moderate NPDR,13 patients were severe NPDR and 9 eyes were proliferative DR (PDR).Severe NPDR and PDR were combine into severe DR group for statistical analysis.All patients underwent direct ophthalmoscope,fundus colorized photography,spectral domain optical coherence tomography (SD-OCT),fasting blood-glucose,glycated hemoglobin and renal function examinations.GFR was evaluated by 99 mTcDTPA.DR degree was evaluated by direct ophthalmoscope and fundus colorized photography.Central subfield (CSF),central macular volume and mean retinal thickness (MRT) were measure by SD-OCT.The correlation between GFR and DR staging and macular retinal thickness were analyzed by Spearman correlation analysis and Pearson correlation analysis.Logistic regression analysis was used to analyze the correlation between GFR and presence of DR.Results GFR was gradually decreased in patients with no DR,mild NPDR,moderate NPDR and severe DR (F=12.32,P＜0.001).Pearson correlation analysis demonstrated that GFR was negatively correlated to CSF (r=-0.202,P=0.010);but no correlation with MRT (r=-0.087,P=0.272).Spearman correlation analysis demonstrated that GFR was negatively correlated to DR staging (r=-0.325,P ＜ 0.001).The difference of DR prevalence rate in normal,slight abnormal renal function and renal insufficiency patients was significant (x2=12.32,P=0.002).Logistic regression analysis demonstrated that lower levels of GFR was significantly associated with presence of DR (95％ confidence interval=1.71-4.32,odds ratio=2.72,P＜0.001).Conclusion In T2DM patients,GFR is negatively correlated to DR staging and CSF.Lower GFR is independent risk factors for DR.