阻塞性睡眠呼吸暂停对糖尿病视网膜病变进展和系统性并发症的影响
Ehsan Rahimy1, Euna B Koo2, Karen M Wai2
1From the Department of Ophthalmology, Horngren Family Vitreoretinal Center, Byers Eye Institute, Stanford University School of Medicine (E.R., E.B.K., K.M.W., C.A.L., A.L.K., P.M.); Department of Ophthalmology, Palo Alto Medical Foundation (E.R.), Palo Alto, California, USA..
American journal of ophthalmology
|August 1, 2024
概括
阻塞性睡眠呼吸暂停 (OSA) 在患有非增殖性糖尿病视网膜病变 (NPDR) 的患者中显著增加了糖尿病视网膜病变进展和视力威胁并发症的风险. OSA也与更高的系统性血管事件和死亡率有关.
科学领域:
- 眼科和睡眠医学 眼科和睡眠医学
- 糖尿病视网膜病变和系统性并发症
- 心血管和脑血管健康
背景情况:
- 非增殖性糖尿病视网膜病变 (NPDR) 是糖尿病的一个常见并发症.
- 阻塞性睡眠呼吸暂停 (OSA) 在糖尿病患者中很普遍,可能会影响微血管健康.
- 对NPDR和OSA对疾病进展和系统性事件的综合影响需要进一步调查.
研究的目的:
- 评估患有NPDR和OSA的患者糖尿病视网膜病变进展的风险.
- 在这个患者队列中评估系统性血管事件的发生率,包括死亡率.
- 确定NPDR和OSA患者眼睛干预的需要.
主要方法:
- 使用TrinetX电子健康记录网络 (超过1.24亿患者) 的回顾性队列研究.
- 已确定患有NPDR,有或没有OSA的患者,不包括患有增殖性糖尿病视网膜病变或糖尿病黄斑的患者.
- 对基线特征进行控制的倾向性得分匹配;结果在1,3,5年后进行评估.
主要成果:
- 患有NPDR和OSA的患者表现出显著增加的增殖性糖尿病视网膜病变 (1-5年) 和糖尿病黄斑胀 (1-5年) 的风险.
- 在OSA队列中观察到眼睛干预的风险增加,包括视内注射和激光光凝.
- 与没有OSA的患者相比,患有NPDR和OSA的患者患中风,心肌梗塞和全因死亡率的风险更高.
结论:
- 阻塞性睡眠呼吸暂停与糖尿病视网膜病变的加速进展与危及视力的并发症有关.
- 患有NPDR和OSA的患者面临眼部干预和严重的全身并发症,包括死亡的风险增加.
- 在NPDR患者中加强OSA查对于主动管理和降低风险至关重要.
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