目的：调查身体测量值与成年糖尿病患者糖尿病视网膜病变（DR）的关系。方法：采用以医院为基础的研究,病例为临床诊断为DR,全部病例均经裂隙灯显微镜,进行详细的眼睛检查和眼底造影,40~75岁的326例患者,并采用眼底照片对DR进行分级。对照为未患DR及其它眼部疾病,同期入住同一医院的326例患者组成,采取1∶1匹配。采用自行设计的调查表对研究对象进行调查,内容包括一般情况、生活方式及既往史等,同时对身高、体质量、腰围（WC）及臀围进行测量,并计算体质指数（BMI）和腰臀比（WHR）。采用多因素Logistic 回归模型对患者身体测量值与DR的比值比（OR）及相应的95%可信区间（CI）进行估计。结果：男性病例组体质量、BMI及WHR与对照组相比较差异均具有统计学意义（P<0.05）。而不同研究对象WC和臀围具有显著性差异（P<0.05）。调整年龄及性别后,随着BMI增加,发生DR的危险性并未随之增加；WC >80cm者与DR的发生具有显著关联性（OR=2.017,95% CI：1.393~2.920,P=0.000）；WHR >0.88者发生DR的危险性明显增加（OR=2.041,95% CI：1.422~2.929,P=0.001）。再进一步调整多种可能的混杂因素后,发现BMI为18.50~23.99kg/m²与DR呈负相关（OR=0.427,95% CI：0.231~0.791,P=0.007）；WC和WHR的结果未发生变化（OR =1.729,95% CI：1.163~2.572,P=0.007；OR=1.991,95% CI：1.353~2.931,P=0.001）。结论：肥胖尤其是腹型肥胖或向心性肥胖在DR的管理方面具有潜在的临床意义,所以应该倡导人们维持正常的WC和WHR,可预防糖尿病和DR的发生。

AIM:To investigate the relationship between anthropometric parameters and diabetic retinopathy (DR) in adults with diabetes. METHODS: A hospital-based study was conducted. All patients underwent detailed eye examinations by using slit-lamp lens photographs, and fundus photographs of both eyes were taken from a retinal camera, fundus photographs were graded for DR. Cases (n=326) were confirmed with DR with 40-75 years old, and controls (n=326) were admitted to same hospital for different diseases not related with gynecologic ocular diseases. Cases and controls were matched with 1∶1. Using a structured interviewer-administrated questionnaire that included information on sociodemographic characteristics, lifestyle habits, detailed medical history, simultaneously, all subjects were interviewed, and height, weight, waist circumference(WC) and hip circumference of the subjects were measured. Then, body mass index (BMI) and waist-to-hipratio (WHR) were calculated. The odds ratios (OR) and 95% confidence intervals (CI) of DR for anthropometric measurements were estimated with unconditional multiple logistic regression models. RESULTS: For men, compared with controls, the results of weigh, BMI, and WHR were statistically significant (P<0.05). The findings of WC and hip circumference were highly significant (P<0.05). Adjusted for age, sex, Greater BMI was not significantly associated with DR. WC >80cm was related with DR (OR=2.017, 95%CI: 1.393-2.920, P=0.000). For WHR >0.88, the risk of DR significantly increased (OR=2.041, 95%CI: 1.422-2.929, P=0.001). After adjustment for multiple potential confounders, BMI 18.50-23.99kg/m² was negative associated with DR (OR=0.427, 95%CI: 0.231-0.791, P= 0.007). Similarly, It was showed increased DR risk with increasing WHR and WC (OR =1.729, 95%CI: 1.163-2.572, P=0.007; OR=1.991, 95%CI: 1.353-2.931, P=0.001, respectively). CONCLUSION: Obesity, especially abdominal obesity or central obesity, has potential clinical implications in the management of DR. Thus, diabetes and DR should be effectively prevented through keeping WC and WHR. 