HbA1c, systolic blood pressure variability and diabetic retinopathy in Asian type 2 diabetics

医学 糖尿病性视网膜病变 内科学 血压 糖尿病 优势比 置信区间 2型糖尿病 心脏病学 内分泌学
作者
Valencia Hui Xian Foo,Joanne Hui Min Quah,Chui Ming Gemmy Cheung,Ngiap Chun Tan,Kyi Lin Ma Zar,Choi Mun Chan,Ecosse L. Lamoureux,Wong Tien Yin,Gavin Siew Wei Tan,Charumathi Sabanayagam
出处
期刊:Journal of Diabetes [Wiley]
卷期号:9 (2): 200-207 被引量:37
标识
DOI:10.1111/1753-0407.12403
摘要

Abstract Background The aim of the present study was to examine the association between variability in HbA1c or systolic blood pressure (SBP) and diabetes‐specific moderate retinopathy in Asians with type 2 diabetes (T2D). Methods A retrospective study was conducted of 172 cases of moderate diabetic retinopathy (DR) cases and 226 controls without DR, matched for age, sex, and ethnicity. Serial HbA1c and SBP (range 3–6 readings) over the 2 years prior to photographic screening of DR were collected. Intrapersonal mean and SD values for HbA1c (iM‐HbA1c and iSD‐HbA1c) and SBP (iM‐SBP and iSD‐SBP) were derived. Moderate DR was assessed from digital retinal photographs and defined as levels >43 using the Early Treatment Diabetic Retinopathy Study scale. Results Cases of moderate DR had higher iM‐HbA1c (8.2 % vs 7.3 %; P = 0.001), iSD‐HbA1c (1.22 vs 0.64; P = 0.001), iM‐SBP (136.8 vs 129.6 mmHg; P = 0.001) and iSD‐SBP (13.3 vs 11.1; P = 0.002) than controls. In the multivariate regression model adjusted for age, gender, ethnicity, duration of diabetes, SBP, and HbA1c, iM‐HbA1c and iM‐SBP were significantly associated with moderate DR (odds ratio [OR] 1.80, 95 % confidence interval [CI] 1.37–2.36; and OR 1.03, 95 % CI 1.01–1.05, respectively). Neither iSD‐HbA1c nor iSD‐SBP were associated with moderate DR. When stratified by HbA1c <7 %, only iSD‐SBP remained significantly associated with moderate DR (OR 1.11, 95 % CI 1.01–1.21). Conclusion In a cohort of Asian patients with T2D, both higher mean HbA1c levels and SBP, but not their variability, were associated with moderate DR. Among those with good glycemic control, wider variability of SBP is associated with moderate DR.
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