Risk factors for diabetic retinopathy in women with type 2 diabetes
T.P. DEMICHEVA
Perm State Medical University named after Academician E.A. Wagner, Perm
Contact details:
Demicheva T.P. — Associate Professor of the Department of Endocrinology and Clinical Pharmacology
Address: 26 Petropavlovskaya St., Perm, Russian Federation, 614990, tel.: +7-912-582-19-50, e-mail: demich-perm@mail.ru
The research objective was to establish the most significant risk factors for diabetic retinopathy in women with type 2 diabetes.
Material and methods. The research base is the City Endocrinological Department (Perm Regional Clinical Hospital) of a large industrial center of Perm region. 121 patients with type 2 diabetes mellitus and diabetic retinopathy were examined. To determine the risk factors for the development of diabetic retinopathy in women with type 2 diabetes, the logistic regression method and the odds ratio calculation were used.
Results. The research showed that 66.1% of hospitalized women had diabetic retinopathy. Statistically significant relationships were established between the likelihood of diabetic retinopathy and clinical and metabolic characteristics. The duration of diabetes mellitus of more than 6 years increased the risk of diabetic retinopathy by 3.5 times, and over 16 years — by 8 times. The chance of developing retinopathy increased by 3 times in patients with non-target values of glycated hemoglobin and with low-density lipoprotein cholesterol > 2.5 mmol/l — by 2.5 times. The predictors of the development of diabetic retinopathy in women with type 2 diabetes mellitus were identified, the quantitative expressions of which were the starting points of the probability of complications: the patient’s age > 52.08 years, the duration of diabetes mellitus > 13.02 years, the total cholesterol level > 5.05 mmol/l.
Conclusion. The calculated risk of developing diabetic retinopathy in women with type 2 diabetes mellitus in percentage terms allows determining the probability of developing pathology as «high», «medium», and «low». Patients with a high probability of developing retinopathy belong to a risk group that requires careful monitoring. The tool proposed to the attending physician allows assessing the condition, timely identifying the pathological impact of risk factors on the body before the appearance of patient complaints and functional disorders, and timely preventing complications.The predictors of the development of diabetic retinopathy in women with type 2 diabetes were identified, the quantitative expressions of which were the starting points for the likelihood of complications.
Key words: prognosis, risk factors, diabetic retinopathy, patients, type 2 diabetes mellitus.
REFERENCES
- International Diabetes Federation IDF Diabetes Atlas. Brussels, Belgium Int Diabetes Fed., 2017. 8th edn. DOI: 10.1289/image.ehp.v119.i032.
- Mkrtumyan A.M., Shadrichev F.E. Diabetic retinopathy: can blindness be prevented? Effective pharmacotherapy. Endokrinologiya, 2014, vol. 5, no. 46, pp. 32–41 (in Russ.).
- Holden B.A., Fricke T.R., Wilson D.A. et al. Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050. Ophthalmology, 2016, vol. 123 (5), rr. 1036–1042.4.
- Flaxman S.R., Bourne R.R.A., Resnikoff S. et al. Global causes of blindness and distance vision impairment 1990—2020: a systematic review and meta-analysis. Lancet Global Health, 2017, vol. 5 (12), rr. 1221–1234.5.
- Pearce I., Simó R., Lövestam-Adrian M., Wong D.T., Evans M. Association between diabetic eye disease and other complications of diabetes: Implications for care. A systematic review. Diabetes Obes Metab, 2019, vol. 21 (3), rr. 467–478.6.
- Maslova O.V. Otsenka effektivnosti lechebnoy pomoshchi bol’nym SD po dannym skrininga mikrososudistykh oslozhneniy: avtoref. diss. … kand. med. nauk [Evaluation of the effectiveness of medical care for patients with diabetes based on screening for microvascular complications. Synopsis of dis. PhD med. sciences]. Moscow, 2011.
- Ivakhnenko O.I., Neroev V.V., Zaytseva O.V. Age-related macular degeneration and diabetic eye damage. Socio-economic aspects of morbidity. Vestnik oftal’mologii, 2021, vol. 137, no. 1, pp. 123–129 (in Russ.).
- Kanyukova Yu.V. Nauchnoe obosnovanie organizatsionnoy tekhnologiiranney diagnostiki i lecheniya diabeticheskoy retinopatii: avtoref. dis. … kand. med [Scientific substantiation of organizational technology for early diagnosis and treatment of diabetic retinopathy. Synopsis of dis. PhD med. sciences]. Orenburg, 2015.
- Neroev V.V., Zaytseva O.V., Mikhaylova L.A. Incidence of diabetic retinopathy in the Russian Federation, according to federal statistics. Rossiyskiy oftal’mologicheskiy zhurnal, 2018, vol. 11, no. 2, pp. 5–9 (in Russ.).
- Bourne R.R.A., Flaxman S.R., Braithwaite T. et al. Magnitude, temporal trends, and projections of the global prevalence of blindness and distance and near vision impairment: a systematic review and meta-analysis. Lancet Global Health, 2017, vol. 5 (9), rr. 888–-897.
- Nazaryan M.G., Arbukhanova P.M. Modern aspects of disability due to pathology of the organ of vision. Kazanskiy meditsinskiy zhurnal, 2015, vol. 2, no. 96, pp. 224–226 (in Russ.).
- UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. BMJ, 1998, vol. 317 (7160), rr. 703–713.
- Trakhtenberg Yu.A., Milen’kaya T.M., Ametov A.S., Demidova T.Yu. Risk factors for diabetic retinopathy. Sakharnyy diabet, 2006, vol. 9, no. 3, pp. 34–38 (in Russ.).
- Suntsov Yu.I., Bolotskaya L.L., Maslova O.V., Kazakov I.V. Epidemiology of diabetes mellitus and forecast of its prevalence in the Russian Federation. Sakharnyy diabet, 2011, no. 1, pp. 15–19 (in Russ.).
- Reshetnikov V.A. Osnovy statisticheskogo analiza v meditsine: uchebnoe posobie [Fundamentals of statistical analysis in medicine: textbook]. Izd-vo: Meditsinskaya informatika i statistika, telemeditsina, 2020. P. 156.
- Ruta L.M., Magliano D.J., Le Mesurier R., Taylor H.R., Zimmet P.Z. Shaw J.E. Prevalence of diabetic retinopathy in Type 2 diabetes in developing and developed countries. Diabetic Medicine, 2013, vol. 30 (4), rr. 387–398.
- Implications of the United Kingdom Prospective Diabetes Study. American Diabetes Assosiation. Clin. Diabetes, 1999, vol. 1 (17), rr. 5–12.
- Kuntysheva K.E. Kliniko-patogeneticheskoe obosnovanie profilaktiki i korrektsii sosudistykh faktorov posle fakoemul’sifikatsii u bol’nykh sakharnym diabetom na fone gipertonicheskoy bolezni: avtoref. dis. … kand. med. nauk [Clinical and pathogenetic rationale for the prevention and correction of vascular factors after phacoemulsification in patients with diabetes mellitus against the background of hypertension. Synopsis of dis. PhD med. sciences]. Moscow, 2015.
- Araki A., Ito H., Hattori A. et al. Risk factors for development of retinopathy in elderly Japanese patients with diabetes mellitus. Diabetes Care, 1993, vol. 8 (16), rr. 1184–1186.
- Klein R., Klein B.E., Moss S.E. Is obesity related to microvascular and macrovascular complications in diabetes? The Wisconsin epidemiologic study of Diabetic Retinopathy. Arch. Intern. Med, 1997, vol. 6 (157), rr. 650–656.
- Kuz’min A.G., Martynov S.A., Shestakova M.V. The role of dyslipidemia in the progression of diabetic retinopathy. Meditsinskiy sovet, 2017, no. 3, pp. 44–46 (in Russ.).