Abstract:AIM:To explore the risk factors for diabetic retinopathy(DR)in patients with type 1 diabetes mellitus(T1DM).
METHODS: A total of 204 patients with T1DM in recent 10a were enrolled. The patients were divided into DR group(n=71)and non-DR group(n=133). The clinical information was collected and relevant biochemical indices were detected. Univariate and multivariate Logistic regression were used to assess the relationship between potential risk factors and DR/proliferative diabetic retinopathy(PDR). The value of risk factors in predicting DR/PDR was evaluated by drawing receiver operating characteristic curve(ROC).
RESULTS: The age of onset, longer duration of diabetes, HbA1c, hypertension, hyperlipidemia, diabetic nephropathy(DN), diabetic peripheral neuropathy(DPN)were related to DR(P<0.05)in patients with T1DM. Longer duration of diabetes, body mass index(BMI), systolic blood pressure(SBP), hyperlipidemia, DN, DPN were related to PDR. Logistic regression analysis indicated that longer duration of diabetes(OR=1.130, P<0.001)and HbA1c(OR=2.734, P<0.001)were risk factors of DR. Longer duration of diabetes(OR=1.144, P=0.005)and DN(OR=6.500, P=0.001)were risk factors of PDR. The results of ROC curve analysis showed that the area under the curve(AUC)of the disease course and HbA1c predicting the occurrence of DR were 0.720 and 0.727, respectively. The cutoff values were 15.1a and 8.2%, respectively. The sensitivity was 50.7% and 76.1%, and the specificity was 86.5% and 59.4%, respectively. The AUC for predicting PDR was 0.713, the best cutoff value was 18.5a, the sensitivity was 73.9%, and the specificity was 60.4%.
CONCLUSION: Retinopathy is associated with age of onset in patients with T1DM. Duration of disease and hyperglycemia are the major influencing factor for DR. HbA1c is associated with DR. DN is associated with PDR occurrence.