糖尿病视网膜病变严重程度与 HbA1c 水平关系的临床研究

P. Sharma, Kavita Kumar, Aditi Dubey, Nitin Kushwaha, Pooja Maravi
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摘要

与非糖尿病患者相比,糖尿病视网膜病变(DR)患者失明的风险更大。HbA1c 是评估糖尿病长期管理的重要指标。因此,本研究的主要目的是探讨 HbA1c 水平与糖尿病视网膜病变严重程度之间的关系。这项为期一年的前瞻性观察临床研究在博帕尔甘地医学院眼科和糖尿病诊所进行,共有 100 名糖尿病患者参与。研究人员详细记录了糖尿病患者的病史。通过全面的眼科检查评估了每位患者的糖尿病视网膜病变状况,并根据早期治疗糖尿病视网膜病变研究(ETDRS)系统进行了分类。研究期间收集了患者的临床数据,包括 HbA1c 水平。研究发现,糖尿病视网膜病变的严重程度与 HbA1c 水平之间存在显著联系。此外,糖尿病病程和血脂水平也与视网膜病变的严重程度有显著关联(P 值小于 0.05)。然而,与不同等级的糖尿病视网膜病变相比,患者的年龄和性别并没有表现出明显的相关性(P 值 > 0.05)。ROC 分析显示,HbA1c 临界值为 7.6% 对检测是否存在糖尿病视网膜病变及其等级最为有效。HbA1c 水平与糖尿病视网膜病变的严重程度之间存在密切的统计学关系。HbA1c 水平越高,说明血糖控制越差,糖尿病视网膜病变的程度也越严重。HbA1c 水平是预测糖尿病视网膜病变是否存在及其严重程度的可靠指标。
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Clinical study on association of diabetic retinopathy severity with HbA1c level
Patients with diabetic retinopathy (DR) have a greater risk of blindness compared to those without diabetes. HbA1c is a valuable indicator used to assess the long-term management of diabetes mellitus. Hence, the main objective of this study was to explore the relationship between HbA1c levels and the severity of diabetic retinopathy.This one-year prospective observational clinical study was conducted at the Department of Ophthalmology and Diabetic Clinic, Gandhi Medical College, Bhopal, involving 100 diabetic patients. Detailed medical histories related to their diabetes were recorded. The diabetic retinopathy status of each patient was assessed through a comprehensive ophthalmologic examination and classified according to the early treatment diabetic retinopathy study (ETDRS) system. Clinical data of the patients, including HbA1c levels, were gathered during the study period.Among the 100 patients, 29% were females, while the remaining 71% were males. A notable finding emerged, revealing a significant link between the severity of diabetic retinopathy and HbA1c levels. Additionally, the duration of diabetes and lipid levels also demonstrated a significant association with the severity of retinopathy (P value < 0.05). However, the age and gender of the patients did not exhibit a significant correlation when compared across different grades of diabetic retinopathy (P value > 0.05). ROC analysis revealed that an HbA1c cutoff of 7.6% was the most effective in detecting both the presence of any diabetic retinopathy and its grades. A strong statistical relationship was found between HbA1c levels and the severity of diabetic retinopathy. Patients with higher HbA1c levels, indicating poorer blood sugar control, showed more severe grades of diabetic retinopathy. HbA1c levels emerged as a reliable predictor for both the presence and severity of diabetic retinopathy.
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