2型糖尿病患者合并糖尿病性视网膜病变的危险因素meta分析  

Meta analysis of risk factors of type 2 diabetic patients with diabetic retinopathy

作　　者：陈丽娟[1] 苏志强 林泽雅 蔡媛 Chen Lijuan;Su Zhiqiang;Lin Zeya;Cai Yuan(Ophthalmology Teaching and Research Office,Zhangzhou Health Vocational College,Zhangzhou 363000,China;Department of Ophthalmology,Zhangzhou Second Hospital,Zhangzhou 363000,China;School of Optometry,Tianjin Medical University,Tianjin 300070,China)

机构地区：[1]漳州卫生职业学院眼视光教研室,漳州363000 [2]漳州市第二医院眼科,漳州363000 [3]天津医科大学眼视光学院,天津300070

出　　处：《国际医药卫生导报》2023年第3期324-332,共9页International Medicine and Health Guidance News

基　　金：福建省教育厅中青年教师教育科研项目(科技类)课题(JAT20866);漳州卫生职业学院院本课题(ZWYZ202103)。

摘　　要：目的系统评价2型糖尿病患者合并糖尿病性视网膜病变的危险因素。方法计算机检索中国知网、万方数据库,搜集有关2型糖尿病患者合并糖尿病性视网膜病变的文献,检索时间为建库至2022年5月1日,由2名研究员按照预先制定的标准独立筛选病例对照研究文献、质量评价、提取资料后,评价纳入研究的偏倚风险,使用Stata 16.0软件进行数据统计分析。结果最终纳入59篇文献,共27926例研究对象。暴露因素中三酰甘油(WMD=0.33,95%CI 0.24~0.45)、低密度脂蛋白胆固醇(WMD=0.30,95%CI 0.12~0.40)、同型半胱氨酸(WMD=3.89,95%CI 0.92~6.85)是脂代谢相关的危险因素;糖化血红蛋白(WMD=1.32,95%CI 1.03~1.61)、空腹血糖(WMD=1.82,95%CI 1.17~2.47)是糖代谢相关的危险因素;收缩压(WMD=6.45,95%CI 4.91~8.00)、舒张压(WMD=4.70,95%CI 3.57~5.84)是血压相关的危险因素;C反应蛋白(WMD=1.34,95%CI 0.55~3.14)是炎性反应相关的危险因素;血尿酸(WMD=60.45,95%CI 20.63~100.27)、尿素氮(WMD=0.90,95%CI 0.46~1.34)、尿微量白蛋白(WMD=180.98,95%CI 72.23~289.74)是肾功能相关的危险因素;其他危险因素包括糖尿病病程(WMD=3.91,95%CI 3.36~4.47)、年龄(WMD=3.74,95%CI 1.91~5.58)、视黄醇结合蛋白4(WMD=12.28,95%CI 7.20~17.37)。结论糖尿病、高血压、高血脂症、高尿酸、高尿素氮、高C反应蛋白、高视黄醇结合蛋白4是2型糖尿病患者合并糖尿病性视网膜病变的危险因素。Objective To systematically evaluate the risk factors of type 2 diabetic patients with diabetic retinopathy(DR).Methods The CNKI and Wanfang databases were searched to collect the literatures about type 2 diabetic patients with DR from the establishment of databases to May 1,2022.Two researchers independently screened case-control studies,assessed the quality,and extracted the data according to the pre-defined criteria,and assessed the risk of bias in included studies.The data were analyzed by the Stata 16.0 software.Results Totally 59 articles including 27926 subjects were included.Among the exposure factors,triglyceride(WMD=0.33,95%CI 0.24-0.45),low density lipoprotein cholesterin(WMD=0.30,95%CI 0.12-0.40),and homocysteine(WMD=3.89,95%CI 0.92-6.85)were risk factors related to lipid metabolism;glycosylated hemoglobin(WMD=1.32,95%CI 1.03-1.61)and fasting plasma glucose(WMD=1.82,95%CI 1.17-2.47)were risk factors related to glucose metabolism;systolic blood pressure(WMD=6.45,95%CI 4.91-8.00)and diastolic blood pressure(WMD=4.70,95%CI 3.57-5.84)were risk factors related to blood pressure;C-reactive protein(CRP)(WMD=1.34,95%CI 0.55-3.14)was a risk factor related to inflammatory response;blood uric acid(WMD=60.45,95%CI 20.63-100.27),urea nitrogen(WMD=0.90,95%CI 0.46-1.34),and microalbumin(WMD=180.98,95%CI 72.23-289.74)were risk factors related to renal function;other risk factors included diabetic duration(WMD=3.91,95%CI 3.36-4.47),age(WMD=3.74,95%CI 1.91-5.58),and retinol-binding protein 4(RBP4)(WMD=12.28,95%CI 7.20-17.37).Conclusion Diabetes,hypertension,hyperlipidemia,high uric acid,high urea nitrogen,high CRP,and high RBP4 are risk factors for type 2 diabetic patients with DR.

关 键 词：糖尿病性视网膜病变 2型糖尿病 危险因素 META分析 

分 类 号：R587.2[医药卫生—内分泌] R774.1[医药卫生—内科学]