109451
论文已发表
注册即可获取德孚的最新动态
IF 收录期刊
- 3.4 Breast Cancer (Dove Med Press)
- 3.2 Clin Epidemiol
- 2.6 Cancer Manag Res
- 2.9 Infect Drug Resist
- 3.7 Clin Interv Aging
- 5.1 Drug Des Dev Ther
- 3.1 Int J Chronic Obstr
- 6.6 Int J Nanomed
- 2.6 Int J Women's Health
- 2.9 Neuropsych Dis Treat
- 2.8 OncoTargets Ther
- 2.0 Patient Prefer Adher
- 2.2 Ther Clin Risk Manag
- 2.5 J Pain Res
- 3.0 Diabet Metab Synd Ob
- 3.2 Psychol Res Behav Ma
- 3.4 Nat Sci Sleep
- 1.8 Pharmgenomics Pers Med
- 2.0 Risk Manag Healthc Policy
- 4.1 J Inflamm Res
- 2.0 Int J Gen Med
- 3.4 J Hepatocell Carcinoma
- 3.0 J Asthma Allergy
- 2.2 Clin Cosmet Investig Dermatol
- 2.4 J Multidiscip Healthc
已发表论文
影响老年 2 型糖尿病患者非增殖性视网膜病变的因素：代谢 - 行为交互作用分析
Authors Xia L, Zheng C, Zhang J, Geng G, Qian X
Received 28 May 2025
Accepted for publication 27 September 2025
Published 15 October 2025 Volume 2025:18 Pages 3329—3342
DOI https://doi.org/10.2147/RMHP.S531865
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Professor Mecit Can Emre Simsekler
Lanting Xia,1,* Chen Zheng,1,* Jiangao Zhang,2 Guiling Geng,1,3 Xiangyun Qian4
1School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu Province, People’s Republic of China; 2Department of Deanery, Nantong Wenci Ophthalmic Hospital, Nantong, Jiangsu Province, People’s Republic of China; 3Nursing Teaching and Research Office, Nantong Institute of Technology, Nantong, Jiangsu Province, People’s Republic of China; 4Nursing Department, Nantong Third People’s Hospital; Affiliated Nantong Hospital 3 of Nantong University, Nantong, Jiangsu Province, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Xiangyun Qian, Nursing Department, Nantong Third People’s Hospital; Affiliated Nantong Hospital 3 of Nantong University, No. 60 Qingnian Zhong Road, Chongchuan District, Nantong, Jiangsu Province, People’s Republic of China, Email qxy0306@163.com Guiling Geng, Nantong Institute of Technology, 211 Yongxing Road, Chongchuan District, Nantong, Jiangsu Province, People’s Republic of China, Email 1153464524@qq.com
Purpose: To investigate the interaction between metabolic and behavioral factors in non-proliferative diabetic retinopathy (NPDR) among elderly patients with type 2 diabetes mellitus (T2DM).
Patients and Methods: A cross-sectional study was conducted from October 2023 to May 2024 using cluster random sampling to recruit elderly patients with T2DM from two tertiary hospitals in Nantong. A self-designed questionnaire was utilized to collect lifestyle and behavioral data. Non-mydriatic fundus photography was used for DR screening, and biochemical indicators were extracted from electronic medical records. Descriptive statistics were applied to analyze demographic characteristics, while univariate and multivariable logistic regression analyses were performed to identify factors influencing NPDR. Interaction models evaluated multiplicative and additive effects between metabolic indicators (low-density lipoprotein cholesterol [LDL-C], urine albumin-to-creatinine ratio [UACR]) and weekly fish consumption frequency on NPDR. Receiver operating characteristic (ROC) curves assessed the diagnostic value of elevated UACR, low fish consumption, and their interaction for NPDR.
Results: Among 978 eligible elderly patients with T2DM, 794 were included, with 306 (38.5%) diagnosed with DR, including 246 (31.0%) with NPDR. Multivariable logistic regression identified diabetes duration, LDL-C, UACR, and weekly fish consumption as independent risk factors for NPDR. Interaction analysis demonstrated significant positive multiplicative (OR=8.89, 95% CI=2.87– 9.52, P< 0.001) and additive interactions (RERI=2.77, API=0.31, SI=1.54) were observed between low fish consumption (< 2 times/week) and severe UACR (> 33.9 mg/mmol). No interactions were found with moderate UACR (3.4– 33.9 mg/mmol) or elevated LDL-C (> 1.8 mmol/L). ROC analysis demonstrated AUC values of 0.840, 0.816, and 0.893 for severe UACR, low fish consumption, and their combined effect, respectively, indicating enhanced diagnostic utility for NPDR.
Conclusion: The synergistic interaction between severe UACR and infrequent fish consumption significantly elevates NPDR risk in elderly patients with T2DM, highlighting its potential as a predictive marker for early intervention.
Keywords: type 2 diabetes mellitus, behavior, non-proliferative diabetic retinopathy, UACR, interaction
1School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu Province, People’s Republic of China; 2Department of Deanery, Nantong Wenci Ophthalmic Hospital, Nantong, Jiangsu Province, People’s Republic of China; 3Nursing Teaching and Research Office, Nantong Institute of Technology, Nantong, Jiangsu Province, People’s Republic of China; 4Nursing Department, Nantong Third People’s Hospital; Affiliated Nantong Hospital 3 of Nantong University, Nantong, Jiangsu Province, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Xiangyun Qian, Nursing Department, Nantong Third People’s Hospital; Affiliated Nantong Hospital 3 of Nantong University, No. 60 Qingnian Zhong Road, Chongchuan District, Nantong, Jiangsu Province, People’s Republic of China, Email qxy0306@163.com Guiling Geng, Nantong Institute of Technology, 211 Yongxing Road, Chongchuan District, Nantong, Jiangsu Province, People’s Republic of China, Email 1153464524@qq.com
Purpose: To investigate the interaction between metabolic and behavioral factors in non-proliferative diabetic retinopathy (NPDR) among elderly patients with type 2 diabetes mellitus (T2DM).
Patients and Methods: A cross-sectional study was conducted from October 2023 to May 2024 using cluster random sampling to recruit elderly patients with T2DM from two tertiary hospitals in Nantong. A self-designed questionnaire was utilized to collect lifestyle and behavioral data. Non-mydriatic fundus photography was used for DR screening, and biochemical indicators were extracted from electronic medical records. Descriptive statistics were applied to analyze demographic characteristics, while univariate and multivariable logistic regression analyses were performed to identify factors influencing NPDR. Interaction models evaluated multiplicative and additive effects between metabolic indicators (low-density lipoprotein cholesterol [LDL-C], urine albumin-to-creatinine ratio [UACR]) and weekly fish consumption frequency on NPDR. Receiver operating characteristic (ROC) curves assessed the diagnostic value of elevated UACR, low fish consumption, and their interaction for NPDR.
Results: Among 978 eligible elderly patients with T2DM, 794 were included, with 306 (38.5%) diagnosed with DR, including 246 (31.0%) with NPDR. Multivariable logistic regression identified diabetes duration, LDL-C, UACR, and weekly fish consumption as independent risk factors for NPDR. Interaction analysis demonstrated significant positive multiplicative (OR=8.89, 95% CI=2.87– 9.52, P< 0.001) and additive interactions (RERI=2.77, API=0.31, SI=1.54) were observed between low fish consumption (< 2 times/week) and severe UACR (> 33.9 mg/mmol). No interactions were found with moderate UACR (3.4– 33.9 mg/mmol) or elevated LDL-C (> 1.8 mmol/L). ROC analysis demonstrated AUC values of 0.840, 0.816, and 0.893 for severe UACR, low fish consumption, and their combined effect, respectively, indicating enhanced diagnostic utility for NPDR.
Conclusion: The synergistic interaction between severe UACR and infrequent fish consumption significantly elevates NPDR risk in elderly patients with T2DM, highlighting its potential as a predictive marker for early intervention.
Keywords: type 2 diabetes mellitus, behavior, non-proliferative diabetic retinopathy, UACR, interaction