A 5-year prospective study of type 2 diabetes patients in Shanghai Xinjing Community 1.The incidence and risk factors of diabetic retinopathy and diabetic macular edema in Chinese type 2 diabetes residents

Background

Diabetic retinopathy (DR) and diabetic macular edema (DME) are common complications of diabetes.Currently abroad study results of incidence and risk factors of DR and DME in type 2 diabetes population varied largely depending on the ethnical difference.However, relevant epidemiological study is rare in China.

Objective

This survey was to assess the 5-year incidence and risk factors of DR and DME in Chinese type 2 diabetic patients.

Methods

A prospective cross-sectional study was performed under the informed consent of the patients.An epidemiological survey for 5-year incidence and risk factors of DR and DME was organized and carried out in 805 type 2 diabetes patients in Shanghai Xinjing Community from 2007 to 2012, and 2007 scheduled as the baseline survey and 2012 scheduled as final survey.The comprehensive examinations were carried out annually during the 5 years, including sociodemographic information, systemic examination and ophthalmological test.DR onset and DME onset grading were performed by OCT and fundus fluorescein angiography (FFA) images based on current international classification.Cumulative incidence of 5 years for DR and DME was determined as the outcome variables, and the associations between potential risk factors and the outcomes were analyzed.

Results

In the baseline time, non-DR were found in 322 type 2 diabetic patients, of which 151 participants developed DR during the follow-up duration, with the 5-year cumulative incidence rate 46.89%.The independent risk factors for DR occurrence were hyperglycemia (odds ratio[OR]=1.12, 95% confidence interval [CI]: 1.01-1.24, P=0.03) and hypertension (OR=1.80, 95%CI: 1.14-2.86, P=0.01). In the baseline time, 629 type 2 diabetes patients were non-DME, of which 124 participants developed DME during the follow-up duration, with the 5-year cumulative incidence rate 19.71%.Hyperglycemia appeared to be the only independent risk factor of DR onset (OR=1.36, 95%CI: 1.24-1.49, P<0.01).

Conclusions

Hyperglycemia and hypertension play an important role in the pathogenesis and development of DR and DME in Chinese type 2 diabetic patients, and intensive glycemic control and hypertension control should be emphasized in diabetic patients.

Diabetes mellitus, type 2/complications; Diabetic retinopathy/epidemiology; Diabetic retinopathy/etiology; Incidence; Blood glucose/metabolism; Hypertension; Risk factors; Chinese/epidemiology; Diabetic macular edema