DEVELOPMENT AND PROGRESSION OF DIABETIC-RETINOPATHY - ADOLESCENTS AT RISK

被引：39

作者：

BONNEY, M ^{[1
]}

HING, SJ ^{[1
]}

FUNG, ATW ^{[1
]}

STEPHENS, MM ^{[1
]}

FAIRCHILD, JM ^{[1
]}

DONAGHUE, KC ^{[1
]}

HOWARD, NJ ^{[1
]}

SILINK, M ^{[1
]}

机构：

[1] ROYAL ALEXANDRA HOSP CHILDREN,RAY WILLIAMS INST PAEDIAT ENDOCRINOL,SYDNEY,NSW,AUSTRALIA

来源：

DIABETIC MEDICINE | 1995年 / 12卷 / 11期

关键词：

DIABETES; RETINOPATHY; ADOLESCENTS; ASSESSMENT;

D O I：

10.1111/j.1464-5491.1995.tb00407.x

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The aims of this study were to evaluate short-term changes in retinopathy in adolescents, and to examine the relationship of these changes to risk factors. Two-hundred and three adolescents, with a median age of 14.5 (range 10.4 to 20.6) yr and a median duration of diabetes of 6.6 (1.1 to 16.3) yr, were included in the study. Retinopathy was assessed on two occasions, using stereoscopic fundus photography; the median time between assessment was 1.3 (0.5 to 3.0) yr. At baseline, 41 % of the adolescents had background retinopathy. When patients were stratified according to the median diabetes duration (DD) (6.6 yr) and glycaemic control over the 12 months prior to assessment (HbA(1C)) (8.4 %), the percentage of retinopathy in each group was: lowDD/lowHbA(1C),, 13 %; lowDD/highHbA(1C) 40 %; highDD/lowHbA(1C) 42 %; and highDD/highHbA(1C) 72 %. Using a 2-step criteria for stability or change in retinopathy, 11 % of the 203 adolescents showed progression of retinopathy, 41 % had stable retinopathy, 5 % showed regression, and 43 % had no retinopathy at either assessment. Change in retinopathy was related to age at baseline assessment (borderline significance, p = 0.06), diabetes duration (p < 0.001), glycaemic control (p < 0.001) and total cholesterol (p = 0.04), and was also related to DD/HbA(1C) group membership (chi(2), p < 0.001). This study highlights the combined adverse effect of long diabetes duration and poor glycaemic control on the development and progression of retinopathy during adolescence, and identifies a group that is likely to show progression over a relatively short period.

引用

页码：967 / 973

页数：7

共 24 条

[1]

Klein R., Klein BEK, Moss SE, Davis MD, DeMets DL, Retinopathy in young‐onset diabetic patients, Diabetes Care, 8, pp. 311-315, (1985)

[2]

Palmberg P., Smith M., Waltman S., Krupin T., Singer P., Burgess D., Et al., The natural history of retinopathy in insulin‐dependent juvenile‐onset diabetes, Ophthalmology, 88, pp. 613-618, (1981)

[3]

Fairchild JM, Hing SJ, Donaghue KC, Bonney M., Fung ATW, Stephens MM, Et al., Prevalence and risk factors for retinopathy in adolescents with type 1 diabetes, Med J Aust, 160, pp. 757-761, (1994)

[4]

Kingsley LA, Dorman JS, Doft BH, Orchard TJ, La Porte RE, Kuller LH, Et al., An epidemiologic approach to the study of retinopathy: The Pittsburgh diabetic morbidity and retinopathy studies, Diabetes Research and Clinical Practice, 4, pp. 99-109, (1988)

[5]

Klein R., Klein BEK, Moss SE, Davis MD, DeMets DL, The Wisconsin epidemiological study of diabetic retinopathy IX. Four year incidence and progression of diabetic retinopathy when age at diagnosis is less than 30 years, Arch Ophthalmol, 107, pp. 237-243, (1989)

[6]

Garg SK, Marshall G., Chase HP, Jackson WE, Archer P., Crews MJ, The use of the Markov process in describing the natural course of diabetic retinopathy, Arch Ophthalmol, 108, pp. 1245-1247, (1990)

[7]

Malone JI, Grizzard WS, Espinoza LR, Achenbach KE, Van Cader TC, Risk factors for diabetic retinopathy in youth, Pediatrics, 73, pp. 756-761, (1984)

[8]

Goldstein DE, Blinder KJ, Ide CH, Wilson RJ, Wiedmeyer H-M, Little RR, Et al., Glycaemic control and development of retinopathy in youth‐onset insulin‐dependent diabetes mellitus, Ophthalmology, 100, pp. 1125-1131, (1993)

[9]

Marshall G., Garg SK, Jackson WE, Holmes DL, Chase HP, Factors influencing the onset and progression of diabetic retinopathy in subjects with insulin‐dependent diabetes mellitus, Ophthalmology, 100, pp. 1133-1139, (1993)

[10]

Screening guidelines for diabetic retinopathy, Ann Intern Med, 116, pp. 683-685, (1992)

← 1 2 3 →