A 5-year prospective study of type 2 diabetes patients in Shanghai Xinjing Community 2.The risk factors of diabetic retinopathy progression in type 2 diabetic residents with controlled blood glucose

Authors:Jin Peiyao,  Peng Jinjuan,  Zou Haidong,  Wang Weiwei,  Fu Jiong,  Bai Xuelin,  Xu Xun,  Zhang Xi
DOI: 10.3760/cma.j.issn.2095-0160.2016.08.018
Published 2016-08-10
Cite as Chin J Exp Ophthalmol, 2016,34(8): 750-755.

Abstract

Background

Some diabetic patients with well controlled blood glucose still had diabetic retinopathy(DR). The risk factor of DR progression in Mongoloid was not clear.

Objective

This study was to assess the 5-year incidence and risk factors of DR progression in type 2 diabetic patients with controlled blood glucose.

Methods

A prospective study was performed under the informed consent of the patients.453 patients with glycosylated hemoglobin A1c (HbA1c)<7.0% in Shanghai xinjing Community from 2007 to 2012 were included in this study.The baseline survey started in 2007 and the final survey ended in 2012.The comprehensive examinations were carried out annually during the follow-up which including general information collection, systemic physical examination, laboratory examination and ophthalmological test.Forward Logistic regression and Cox regression were performed to analysis potential risk factors of DR progression.Kaplan-Meier survival analysis was performed to compare DR progress probability of patients with different HbA1c level.This study was approved by Shanghai First People’s Hospital Ethics Committee

Results

Among the 453 type 2 diabetic patients, 146 developed or progressed DR during the follow-up.The 5-year DR progression rate was 32.23%.Logistic regression showed that baseline HbA1c level was the only independent risk factor of DR progression [P<0.01, odds ratio(OR)=2.84, 95% confidence interval (CI): 2.11-3.82]. Cox regression results showed that the incidence of DR progression in the baseline HbA1c≥5.2% patients was 1.97 times higher than that in the baseline HbA1c<5.2% patients [P<0.01, relative risk(RR)=1.97, 95%CI: 1.32-2.93].

Conclusions

The progression rate of DR in type 2 diabetic patients with controlled blood glucose level is still high.In order to reduce DR progression in Chinese type 2 diabetic patients, the targeted HbA1c should be set to a lower level (under 5.2%) under the premise of absent severe side effects.

Key words:

Diabetes, type 2; Diabetic retinopathy; Hemoglobin A, glycosylated; Risk factor

Contributor Information

Jin Peiyao
Department of Ophthalmology, Shanghai First People’s Hospital, Shanghai Jiao Tong University, Shanghai 200080, China
Peng Jinjuan
Department of Ophthalmology, Shanghai First People’s Hospital, Shanghai Jiao Tong University, Shanghai 200080, China
Zou Haidong
Department of Ophthalmology, Shanghai First People’s Hospital, Shanghai Jiao Tong University, Shanghai 200080, China
Wang Weiwei
Xinjing Community Health Service Center, Shanghai 200335, China
Fu Jiong
Xinjing Community Health Service Center, Shanghai 200335, China
Bai Xuelin
Xinjing Community Health Service Center, Shanghai 200335, China
Xu Xun
Department of Ophthalmology, Shanghai First People’s Hospital, Shanghai Jiao Tong University, Shanghai 200080, China
Zhang Xi
Department of Ophthalmology, Shanghai First People’s Hospital, Shanghai Jiao Tong University, Shanghai 200080, China
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