Abstract:AIM: To analyze the related factors influencing the progression of diabetes retinopathy(DR).
METHODS: This study retrospectively collected the patients with nonproliferative diabetes retinopathy(NPDR)and followed up at the same time. A total of 77 patients in the cohort who progressed from NPDR to proliferative diabetes retinopathy(PDR)were taken as the disease progression group, while 115 NPDR patients who did not progress to PDR were selected as the observation group for a nested case-control study, comparing the general information and laboratory indicators of NPDR and PDR groups, taking general data and laboratory indicators as independent variables and PDR as outcome variables; Finally, diagnostic tests were conducted to evaluate the independent influencing factors of DR progression.
RESULTS: PDR group was younger than patients in the NPDR group(P=0.001), and the course of diabetes was longer(P=0.01); Glycated hemoglobin(HbA1c; P=0.001), blood urea nitrogen(BUN; P=0.003), erythrocyte sedimentation rate(ESR; P<0.001), and homocysteine(HCY; P=0.001)in the PDR group were significantly higher than those in the NPDR group, while mean red blood cell hemoglobin(MCH; P=0.043)and mean red blood cell hemoglobin concentration(MCHC; P=0.002)were significantly lower than those in the NPDR group. The independent influencing factors for screening DR progression include HbA1c(OR=1.587, P<0.001), BUN(OR=1.456, P=0.008), MCH(OR=0.540, P=0.038), ESR(OR=1.122, P=0.005), and HCY(OR=1.838, P=0.002). ROC curve was analyzed to determine the optimal diagnostic cut-off point for the influencing factors of DR progression: HbA1c: 8.18%; BUN: 5.46 mmol/L; ESR: 8.93 mm/h; HCY: 13.95 μmol/L.
CONCLUSION: Research has shown that HbA1c, BUN, MCH, ESR, and HCY are independent risk factors for DR progression. Among them, HbA1c, BUN, ESR, and HCY are independent risk factors for DR progression, while MCH is an independent protective factor for DR progression.