Glycated hemoglobin A1C level and the risk of diabetic retinopathy in Africa: A systematic review and meta-analysis

医学 糖化血红素 血糖性 糖尿病性视网膜病变 荟萃分析 漏斗图 出版偏见 内科学 置信区间 视网膜病变 优势比 糖尿病 2型糖尿病 内分泌学 胰岛素
作者
Wondimeneh Shibabaw Shiferaw,Tadesse Yirga Akalu,Melaku Desta,Ayelign Mengesha Kassie,Pammla Petrucka,Hilina Ketema Assefa,Yared Asmare Aynalem
出处
期刊:Diabetes and Metabolic Syndrome: Clinical Research and Reviews [Elsevier BV]
卷期号:14 (6): 1941-1949 被引量:8
标识
DOI:10.1016/j.dsx.2020.10.003
摘要

Diabetic retinopathy is a frequent cause of acquired blindness worldwide. Various studies have reported the effects of glycemic control on the risk of diabetic retinopathy, but the results remain inconclusive. Therefore, this meta-analysis was performed to determine the association between glycated hemoglobin A1C levels and diabetic retinopathy in Africa. A systematic search was performed using the PubMed, African Journals Online, Google Scholar, Scopus, and Wiley Online Library from inception to June 11, 2020, for observational studies addressing the association of hemoglobin A1c levels with diabetic retinopathy. The I2 statistic was used to check heterogeneity across the included studies. A random-effects model was applied to estimate the pooled effect size (OR) and respective 95% confidence interval across studies. A funnel plot and Egger's regression test were used to determine the presence of publication bias. Sensitivity analysis was used to determine the effect of a single study on the overall estimation. All statistical analyses were performed using STATA™ Version 14 software. A total of 23 articles with 18,099 study participants were included in this meta-analysis. In the present review, when HbA1c was analyzed as a categorical variable, poor glycemic control (HbA1c >7%) was associated with an increased risk of diabetic retinopathy when compared with good glycemic control (OR = 1.25; 95% CI; 1.14, 1.38). Similarly, when HbA1c was analyzed as a continuous variable, a higher HbA1c was associated with an increased risk of diabetic retinopathy (MD: 0.42, 95% CI; 0.11, 0.98). Our meta-analysis indicated evidence for poor glycemic control as an independent risk factor for the development of diabetic retinopathy in patients with diabetes mellitus. Therefore, the authors suggest that clinicians should advise their patients with diabetes to maintain their HbA1c levels within the normal range.
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