Analysis of macular retinal thickness characteristics in diabetic kidney disease patients with different blood pressure levels

doi:10.11958/20252128

Abstract

Abstract:

Objective To compare the macular retinal thickness characteristics of diabetic kidney disease (DKD) patients with different blood pressure levels and explore the relationship between blood pressure and macular retinal damage in DKD patients. Methods A total of 435 DKD patients were selected and divided into four groups based on medical history and blood pressure: the non-hypertensive group (NH group, n=100), the well-controlled blood pressure group (G0 group, n=176), the grade 1 hypertension group (G1 group, n=118) and the grade 2 hypertension group (G2 group, n=41). General information, routine laboratory test results as well as the average thickness of the macular retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), ganglion cell complex (GCC), choroidal layer (CL) and central macular retinal thickness (CMT) were compared between the four groups. The correlation between macular retinal thickness in both eyes and clinical data was analyzed. Results Compared with the G1 group and the G2 group, the G0 group had a longer duration of hypertension. Compared to the NH group, the G2 group had higher fasting plasma glucose (FPG). Compared to the G0 group, the G1 group and the G2 group had higher FPG, and the G2 group had higher glycated hemoglobin (HbA1c) and lower estimated glomerular filtration rate (eGFR). Compared to the NH group, the G0 group had decreased thickness in the GCL and GCC (P < 0.05). The macular retinal thickness of the GCL and GCC in both eyes was negatively correlated with diastolic blood pressure (r = -0.158 and -0.195, respectively, P < 0.05). Conclusion Macular retinal thickness is helpful in assessing the long-term effects of hypertension on optic nerve and microvascular damage in DKD patients.

Key words: diabetic kidney disease, retina, retinal ganglion cells, blood pressure, tomography, optical coherence

CLC Number:

R544.1，R774

Figures/Tables 4

References 21

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组别		n	性别				年龄/岁
组别		n	男		女		年龄/岁
NH组		100	36（36.0）		64（64.0）		68.87±7.07
G0组		176	57（32.4）		119（67.6）		69.60±6.88
G1组		118	49（41.5）		69（58.5）		69.32±5.61
G2组		41	19（46.3）		22（53.7）		69.55±6.84
χ²或F			4.221				0.271
组别	BMI/（kg/m²）			糖尿病病程/年		高血压病程/年
NH组	26.22±3.40			9.91±5.86		-
G0组	26.94±3.59			11.16±6.17		15.31±6.18
G1组	27.17±3.77			12.41±5.16		10.42±6.68^a
G2组	27.16±3.15			11.32±6.71		11.21±5.42^a
F	1.519			1.811		23.563^＊＊

组别		n	性别				年龄/岁
组别		n	男		女		年龄/岁
NH组		100	36（36.0）		64（64.0）		68.87±7.07
G0组		176	57（32.4）		119（67.6）		69.60±6.88
G1组		118	49（41.5）		69（58.5）		69.32±5.61
G2组		41	19（46.3）		22（53.7）		69.55±6.84
χ²或F			4.221				0.271
组别	BMI/（kg/m²）			糖尿病病程/年		高血压病程/年
NH组	26.22±3.40			9.91±5.86		-
G0组	26.94±3.59			11.16±6.17		15.31±6.18
G1组	27.17±3.77			12.41±5.16		10.42±6.68^a
G2组	27.16±3.15			11.32±6.71		11.21±5.42^a
F	1.519			1.811		23.563^＊＊

组别			n	FPG/（mmol/L）		HbA1c/%		Cr/（μmol/L）
NH组			100	7.05±2.19		7.38±1.33		77.11±31.24
G0组			176	6.70±3.07		7.11±1.13		77.98±31.14
G1组			118	7.39±1.28^b		7.39±1.28		72.52±32.59
G2组			41	7.67±1.52^ab		7.67±1.52^b		78.26±39.19
F				6.729^＊＊		4.130^＊＊		0.762
组别	eGFR/ mL/（min·1.73 m²）						TC/（mmol/L）			TG/（mmol/L）
NH组	88.48±31.81						5.16±1.36			2.19±0.78
G0组	94.76±35.93						5.24±1.52			2.06±0.93
G1组	84.70±20.39						5.41±1.47			1.99±0.72
G2组	79.43±29.79^b						5.31±1.28			2.36±0.95
F	2.685^＊						0.574			0.609
组别		LDL-C/（mmol/L）			HDL-C/（mmol/L）				Hb/（g/L）
NH组		3.03±1.03			1.37±0.41				138.58±14.27
G0组		2.98±1.06			1.44±0.43				135.02±15.30
G1组		3.19±0.98			1.38±0.35				136.81±14.14
G2组		3.11±1.14			1.47±0.56				1.47±0.56
F		0.990			1.019				0.548

组别			n	FPG/（mmol/L）		HbA1c/%		Cr/（μmol/L）
NH组			100	7.05±2.19		7.38±1.33		77.11±31.24
G0组			176	6.70±3.07		7.11±1.13		77.98±31.14
G1组			118	7.39±1.28^b		7.39±1.28		72.52±32.59
G2组			41	7.67±1.52^ab		7.67±1.52^b		78.26±39.19
F				6.729^＊＊		4.130^＊＊		0.762
组别	eGFR/ mL/（min·1.73 m²）						TC/（mmol/L）			TG/（mmol/L）
NH组	88.48±31.81						5.16±1.36			2.19±0.78
G0组	94.76±35.93						5.24±1.52			2.06±0.93
G1组	84.70±20.39						5.41±1.47			1.99±0.72
G2组	79.43±29.79^b						5.31±1.28			2.36±0.95
F	2.685^＊						0.574			0.609
组别		LDL-C/（mmol/L）			HDL-C/（mmol/L）				Hb/（g/L）
NH组		3.03±1.03			1.37±0.41				138.58±14.27
G0组		2.98±1.06			1.44±0.43				135.02±15.30
G1组		3.19±0.98			1.38±0.35				136.81±14.14
G2组		3.11±1.14			1.47±0.56				1.47±0.56
F		0.990			1.019				0.548

组别		n	RNFL	GCL
NH组		100	34.70±7.98	69.65±8.47
G0组		176	32.83±7.58	65.85±9.53^a
G1组		118	33.73±5.61	68.69±7.02
G2组		41	34.41±6.52	67.60±7.94
F			1.672	4.573^＊＊
组别	GCC		CL	CMT
NH组	104.35±14.62		170.54±41.31	253.78±49.75
G0组	98.58±15.93^a		173.52±31.95	263.03±22.93
G1组	103.34±11.12		171.03±23.43	265.01±19.69
G2组	101.04±9.34		183.96±45.14	266.28±19.79
F	4.011^＊＊		0.518	1.593