Prevalence And Risk Factors Of Diabetic Nephropathy And Diabetic Retinopathy And The Relationship Between Two Complications In Type2Diabetes Patients In Rural Area Of Yiling In Yichang

Objective: To explore the prevalence and risk factors of diabetic nephropathy and diabeticretinopathy and the Relationship between these two diseases in type2diabetes patients inrural area of Yiling in Yichang.Methods: The survey was conducted from October to November in2010in rural area ofYiling in Yichang. This study enrolled349participates using stratified cluster samplingmethod. We formulated a questionnaire survey which included basic demographicinformation (age, gender, socioeconomic status, education level, smoking history, drinkinghistory, behavioral and dietary lifestyle etc), duration of diabetes, family history of diabetes,history of diabetic vascular complications etc were carried out. Clinical examination whichcontained height, weight, waist circumference, hip circumference, blood pressure, bloodglucose, insulin level, HbA1c, serum lipid, urinary creatinine, urinary microalbumin etcwere detected as clinical data. Special examinations including diabetic retinopathyscreening and lower extremity vascular ultrasound were performed. Then keep the bloodsamples for laboratory study on ICAM-1，VCAM-1，TNF-α，ET-1. Data were input byEPIDATA software, then analyzed by SPSS18.0software. All data were described by mean±standard deviation or percentage. Analysis of variance (ANOVA) were used to comparethe quantitative data, and χ2test was used to compare the prevalence. Ordinal logisticregression was performed for the screening of risk factors in different stages of diabeticnephropathy and diabetic retinopathy. The relationship between UACR and each factor wasexplored by bivariate correlation analysis. P value less than0.05was consideredstatistically significant.Results:1. The prevalence of diabetic nephropathy and retinopathy in type2diabetes in rural area of Yiling in Yichang is approximately40.4%and86.9%.2. Significant differences were observed in waist height ratio, DM duration, hypertensionprevalence, HbA1c, triglycerides, blood glucose（fasting,0.5h,2h）, HOMA-IR,VCAM-1level in different groups of incidence and development of diabeticnephropathy. Waist height ratio, DM duration, HbA1c, VCAM-1level and hypertensionwere risk factors associate with the incidence and development of diabetic nephropathy.DM duration, waist height ratio, blood pressure (systolic blood pressure, diastolic bloodpressure), blood glucose（fasting,0.5h,2h）, HbA1c, triglycerides, HOMA-IR, TNF-α,ET-1, VCAM-1level were positively correlated with UACR. In contrast, Homa-βwhich reflected beta cell function was negatively correlated with UACR.3. Significant differences were observed in DM duration, blood glucose（fasting,0.5h,2h）,HbA1c, VCAM-1, UACR and family history of diabetes in different group of incidenceand development of diabetic retinopathy. DM duration,2h postprandial blood glucose、VCAM-1、ET-1、UACR level were risk factors associate with the incidence anddevelopment of diabetic retinopathy.4. UACR level was a significant difference among the groups of incidence anddevelopment of diabetic retinopathy. Closely relationship between DN and DR inincidence and development was observed with parallel features.Conclusion: The prevalence of diabetic nephropathy was consistent with the domestic andinternational level in rural area of Yiling. However, the prevalence of diabetic retinopathy ismuch higher. Waist height ratio, DM duration, HbA1c, VCAM-1and hypertension wererisk factors associate with the occurrence and severity of diabetic nephropathy. DMduration,2h postprandial blood glucose、VCAM-1、ET-1、UACR level were risk factorsassociate with the incidence and development of diabetic retinopathy. The occurrence anddevelopment of DR and DN was observed with parallel characteristics.