Correlation between hemoglobin level and diabetic retinopathy in patients with type 2 diabetes mellitus
10.3760/cma.j.cn311282-20230221-00080
- VernacularTitle:2型糖尿病患者血红蛋白水平与糖尿病视网膜病变的相关性研究
- Author:
Fangli TANG
1
;
Lili XING
;
Wenjun WANG
;
Xionggao HUANG
;
Jing SHEN
;
Taojun LI
;
Qingqing LOU
Author Information
1. 海南医学院，国际护理学院，海口 571199
- Keywords:
Diabetic retinopathy;
Diabetes mellitus, type 2;
Hemoglobin;
Anemia
- From:
Chinese Journal of Endocrinology and Metabolism
2023;39(7):560-564
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the relationship between hemoglobin(Hb) level and the risk of diabetic retinopathy(DR) in patients with type 2 diabetes mellitus(T2DM).Methods:This study was a prospective cohort study. A total of 1 730 T2DM patients without DR, who received regular management at the Li′s Clinic in Taiwan, China starting from 2002, were selected as the study population. All patients underwent annual dilated fundus examination by professional ophthalmologists. General patient information and laboratory results were collected and analyzed. Based on the occurrence of DR during patient follow-up, patients were divided into the DR group and the non-DR(NDR) group. The impact of Hb levels on DR was explored using a generalized linear mixed model, and the relationship between Hb levels and DR was studied using Cox proportional hazards regression model.Results:After an average follow-up of 9.79 years, 481 patients with DR were detected. Compared with NDR group, DR group displayed a longer course of diabetes, higher rates of cataract, insulin use, and anemia, and higher systolic blood pressure, HbA 1C, and UACR as well as lower Hb. The results of the generalized linear mixed model showed a negative correlation between Hb and the occurrence of DR( β=-0.015, P<0.001). The Cox proportional hazards regression model showed that, after adjusting for confounding variables and based on quartiles of average Hb levels during follow-up, the risk of developing DR increased by 56.9% in the Q1 group(Hb≤127 g/L) compared to the Q4 group(Hb≥142 g/L). The cumulative risk plot showed that, after adjusting for confounding variables, the Q1 group had the highest cumulative risk of developing DR, and the difference was statistically significant( P<0.05). Conclusion:Hb was negatively correlated with DR, and the lower Hb levels were associated with the occurrence of DR, independent of other influencing factors.
