Development of Proliferative Diabetic Retinopathy in African-Americans and Whites With Type 1 Diabetes

作者：Cynthia Lee Arfken, Philip L. Reno, Julio V. Santiago, Ronald Klein · 发表于：Diabetes Care · 年份：1998 · DOI：10.2337/diacare.21.5.792 · 被引用次数：47 · 研究领域：Retinal Diseases and Treatments、Retinal Imaging and Analysis、Diabetes Management and Research

OBJECTIVE: To investigate the comparable risk of developing proliferative diabetic retinopathy (PDR) in African-Americans and whites with type 1 diabetes. RESEARCH DESIGN AND METHODS: Using a cohort design with the sample drawn from medical records, the sample consisted of 312 people with type 1 diabetes (97 African-Americans, 215 whites) having at least two visits to a Model Demonstration Unit with gradeable fundus photographs (stereo, color, 7 standard fields). Excluded were subjects with preexisting or treated PDR or hemoglobinopathy. Masked grading of the fundus photographs was conducted at the Wisconsin Reading Center. RESULTS: At baseline, African-Americans had poorer glycemic control (mean HbA1 of 11.3 vs. 10.0%, P < 0.0001), higher systolic blood pressure (mean of 117 vs. 110 mmHg, P < 0.001), and were older (mean of 26.8 vs. 19.3 years, P < 0.0001) than the white subjects. African-Americans also tended to have slightly longer duration of diabetes and length of follow-up. In the African-Americans, 17.5% developed PDR, compared with 10.2% in the 215 whites, for an odds ratio (OR) of 1.86 (95% CI 0.93-3.70). When adjusted for baseline glycemic control, retinopathy grade, and length of follow-up, race was not a significant risk factor (OR = 0.73, 95% CI 0.30-1.78). CONCLUSIONS: African-Americans with type 1 diabetes may have a higher rate of developing PDR. The observed racial difference, however, is attributable to the presence of a worse risk factor profile, especially...