Analysis of risk factors for diabetic retinopathy without proteinuria in type 2 diabetic patients / 医学研究生学报

ABSTRACT

Objective　To analyze risk factors for diabetic retinopathy without proteinuria in type 2 diabetic patients．　Methods　The clinical data of type 2 diabetic patients were retrospectively analyzed. These patients were divided into two groups based on the results of fundus examination. Basic clinical data were compared in simple diabetic retinopathy (DR, without albuminuria and DPN) group including 169 cases and non-diabetic retinopathy (NO-DR, without microvascular complications) group including 208 cases. Logistic regression analysis was used to analyze the risk factors of DR. Among DR, 60 patients were mild non-proliferation DR (NPDR), 82 patients were moderate NPDR, 20 patients were severe NPDR and 7 patients were proliferation DR (PDR). Severe NPDR and PDR were combined into severe DR group. The correlation between risk factors and DR staging were analyzed by Pearson correlation analysis.　Results　The results showed that duration of diabetes, HbA1c, systolic blood pressure, diastolic blood pressure, postprandial blood glucose, triglyceride, serum creatinine, cystatin C and ratio of statin were higher in DR group, but age at onset of diabetes, CKD-EPI formula estimated GFR, fasting c-peptide and postprandial c-peptide were lower in DR group than that in NDR group (P<0.05). Logistic regression analysis showed that young age at onset of diabetes (OR0.914, P≤0.001), hypertriglyceridemia (OR1.369, P<0.05), high systolic pressure (OR1.041, P<0.01) and reduced GFR (OR0.912, P≤0.001) were the risk factors of DR. Pearson correlation analysis demonstrated that GFR was negatively correlated to DR staging (r=-0.513, P<0.001), TG (r=0.110，P<0.033) and SBP (r=0.231, P<0.001） were positive correlated to DR staging.　Conclusion　In addition to the traditional factors, simple diabetic retinopathy in type 2 diabetic patients was related to young age at onset of diabetes, high systolic pressure, hypertriglyceridemia and reduced eGFR. eGFR decline occurred before the proteinuria and associated with the development of DR was a predicted factor of DR.