OBJECTIVE:We determined the longitudinal association of glucose metabolism with retinopathy in a sample of the Australian population. RESEARCH DESIGN AND METHODS:The Australian Diabetes Obesity and Lifestyle (AusDiab) study is a national, longitudinal study of adults aged > or =25 years from 42 randomly selected areas of Australia. Retinopathy was assessed at baseline in 1999-2000 and 5 years later in 2004-2005 in participants identified as having diabetes (based on self-report and oral glucose tolerance test) and impaired glucose metabolism and in a random sample with normal glucose tolerance. Complete retinal data were available for 1,192 participants. Photographs were graded at two time points according to a simplified version of the Wisconsin grading system. RESULTS:The 5-year incidences of retinopathy were 13.9 and 3.0% among those with known and newly diagnosed diabetes at baseline, respectively. Of those who developed incident newly diagnosed diabetes at follow-up, 11.9% had retinopathy at baseline compared with 5.6% of those who did not progress to incident newly diagnosed diabetes (P = 0.037). After adjustment for factors identified as risk factors for diabetes, individuals with retinopathy signs at baseline were twice as likely to develop incident newly diagnosed diabetes compared with those who did not have retinopathy signs at baseline. CONCLUSIONS:The 5-year incidence of retinopathy was 13.9% among individuals with known diabetes. Nondiabetic individuals with retinopathy signs at baseline had a twofold higher risk of developing incident newly diagnosed diabetes 5 years later. This result provides further evidence that mild retinopathy signs may be a preclinical marker of underlying microvascular disease and future diabetes risk.

译文

目的:我们确定了澳大利亚人群样本中葡萄糖代谢与视网膜病变的纵向相关性。
研究设计和方法:澳大利亚糖尿病肥胖与生活方式研究(AusDiab)是一项全国性的纵向研究,研究对象是来自澳大利亚42个随机选择地区的25岁以上的成年人。在1999-2000年和5年后的2004-2005年对基线视网膜病变进行评估,这些参与者被确定患有糖尿病(基于自我报告和口服葡萄糖耐量试验)并且糖代谢受损,并且在随机样本中具有正常的葡萄糖耐量。完整的视网膜数据可供1,192名参与者使用。根据简化版的威斯康星州评分系统,在两个时间点对照片进行了评分。
结果:在基线时已知和新诊断的糖尿病患者中,视网膜病变的5年发生率分别为13.9%和3.0%。在随访中发展为新诊断为糖尿病的人中,基线时有11.9%的视网膜病变,而未进展为新诊断为糖尿病的人为5.6%(P = 0.037)。在对确定为糖尿病危险因素的因素进行校正后,基线时视网膜病变征象的个体发生新近诊断出的糖尿病的可能性是基线时没有视网膜病变征象的个体的两倍。
结论:已知糖尿病患者的5年视网膜病变发生率为13.9%。基线时具有视网膜病变征象的非糖尿病患者在5年后患新诊断出的糖尿病的风险要高两倍。该结果提供了进一步的证据,表明轻度的视网膜病变征象可能是潜在的微血管疾病和未来糖尿病风险的临床前标志物。

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