Background. The relationship between onset age of diabetes and diabetic retinopathy (DR) is controversy and not concluded. Therefore, this hospital-based case-control study aimed to investigate the influence of diabetes onset age on the development of DR in patients with type 2 diabetes (T2D), independent of diabetic duration and HbA1c levels. Methods. A sample of 780 T2D patients with diabetic duration of 10–20 years and glycated hemoglobin (HbA1c) ≥7% were enrolled in the study. 338 T2D patients with onset age ≤45 years were further selected as cases (early onset) and 79 with onset age ≥ 55 years were chosen as controls (elderly onset). International Clinical Diabetic Retinopathy Disease Severity Scale was applied to estimate the severity of DR. Results. The prevalence of DR and proliferative diabetic retinopathy (PDR) was notably increased in the early onset group. When stratified by duration of diabetes, the impact of younger age on the risk of DR turned to be greatest in patients with diabetic duration ≥15 years (OR = 5.202, 95% CI 2.625–10.310). In groups stratified by HbA1c, the risk of DR was highest in patients with younger onset age and HbA1c ≥ 9% (OR = 3.889, 95% CI 1.852–8.167). Compared with the elderly onset group, the risk of DR (OR = 1.776, 95% CI = 1.326–2.380,  < 0.001) and PDR (OR = 1.605, 95% CI = 1.106–2.329,  = 0.013) in younger diagnosed patients was increased after multivariable adjustment. Conclusions. Age of onset was an independent risk factor for developing DR and PDR. This suggests that it is urgent to closely monitor and treat the metabolic disorders in younger T2D patients to delay the occurrence and progression of DR.

中文翻译：

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早发年龄增加了病程 10-20 年且 HbA1C ≥ 7% 的 2 型糖尿病患者发生糖尿病视网膜病变的风险：一项基于医院的病例对照研究

背景。糖尿病的发病年龄与糖尿病视网膜病变 (DR) 之间的关系存在争议且尚未得出结论。因此，这项基于医院的病例对照研究旨在调查糖尿病发病年龄对 2 型糖尿病 (T2D) 患者 DR 发展的影响，独立于糖尿病病程和 HbA1c 水平。方法。该研究招募了 780 名糖尿病病程为 10-20 年且糖化血红蛋白 (HbA1c) ≥ 7% 的 T2D 患者样本。进一步选择338例发病年龄≤45岁的T2D患者作为病例（早发），79例发病年龄≥55岁的患者作为对照（老年发病）。应用国际临床糖尿病视网膜病变严重程度量表来估计 DR 的严重程度。结果. DR 和增殖性糖尿病视网膜病变 (PDR) 的患病率在早发组显着增加。当按糖尿病病程分层时，糖尿病病程≥15 年的患者中，年轻年龄对 DR 风险的影响最大（OR = 5.202，95% CI 2.625–10.310）。在按 HbA1c 分层的组中，发病年龄较轻且 HbA1c ≥ 9% 的患者发生 DR 的风险最高（OR = 3.889，95% CI 1.852–8.167）。与老年发病组相比， 年轻确诊患者的 DR（OR = 1.776, 95% CI = 1.326–2.380,  < 0.001）和 PDR（OR = 1.605, 95% CI = 1.106–2.329, = 0.013）风险为多变量调整后增加。结论. 发病年龄是发生 DR 和 PDR 的独立危险因素。这表明密切监测和治疗年轻 T2D 患者的代谢紊乱以延缓 DR 的发生和进展迫在眉睫。