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서울시 당뇨예방사업의 제2형 당뇨 환자에서 당뇨망막병증과 프래밍험 위험도 점수와의 관계

The Association between Diabetic Retinopathy and Framingham Risk Score in Koreans with Type II Diabetes

송수정|이은정|배정훈|박철영|김다영
대한안과학회 (The Korean Ophthalmological Society)|2016.05|대한안과학회지 (Journal of The Korean Ophthalmological Society)|제57권 제5호|pp. 779-785

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키워드

Diabetic retinopathyFramingham Risk ScoreCardiovascular complicationMacrovascular complicationMicrovascular complication
주제분류안과학

초록

목적: 제2형 당뇨병 환자에서 당뇨망막병증과 프래밍험 위험도 점수(Framingham Risk Score) 간의 관계를 통해 당뇨망막병증에서 심혈관계 합병증의 위험성을 알아보고자 하였다. 대상과 방법: 2008년 9월부터 2009년 9월까지 서울시 당뇨병예방사업에 참여한 40세 이상을 대상으로 하였다. 당뇨망막병증의 단계는 1단계는 당뇨망막병증 없음, 2단계는 경도 비증식당뇨망막병증, 3단계는 중등도 비증식당뇨망막병증, 4단계는 중증 비증식당뇨망막병증, 5단계는 증식당뇨망막병증으로 하였다. 1단계는 제1군으로, 2단계는 제2군으로, 3단계와 4단계, 5단계를 합쳐서 제3군으로 하였으며 집단 간의 프래밍험 위험도 점수가 어떻게 변화하는지 일원배치 분산분석 방법을 이용하여 확인하였다. 결과: 총 529명 중 제1군은 403명, 제2군은 22명, 제3군은 104명으로 분포됐다. 당뇨망막병증의 중증도가 증가함에 따라 나타난 평균프래밍험 위험도 점수는 제1군에서 10.89 ± 7.98, 제2군에서 12.25 ± 10.84, 제3군에서 13.25 ± 10.66으로 나타났으며, 제1군과 제3군 간의 차이는 통계적으로 유의하였다(p=0.014). 결론: 우리의 연구에서 당뇨망막병증이 심할수록, 프래밍험 점수는 유의하게 증가하였다. 심혈관계 질환이 세계적으로 사망의 가장 큰 원인 중 하나이며, 당뇨망막병증의 확인이 인체에서 쉽게 접근 가능하다는 점을 고려할 때 그 유용성은 적지 않을 것으로 사료된다. 하지만 본 연구는 단면연구로 진행되었기 때문에 정확한 인과관계를 알기는 어려우며, 향후 추가적 연구가 필요할 것이다.

Abstract

Purpose: In this study, we compared the risk of cardiovascular complications between diabetic retinopathy (DR) groups based on the Framingham Risk Score. Methods: Subjects 40 years of age or older were enrolled in the present study from September 2008 to September 2009. Five scales were used to evaluate the severity of DR for the most severely affected eye in each patient: no DR, mild nonproliferative DR (NPDR), moderate NPDR, severe NPDR and proliferative DR (PDR). The first group included no DR patients and the second group included mild NPDR patients. The third group included moderate NPDR, severe NPDR and PDR patients. The Framingham Risk Score was analyzed among the groups to determine whether a difference in score existed. Results: DR was found in 126 subjects. The first group included 403 subjects, the second group 22 subjects and the third group 104 subjects. The average Framingham Risk Score that appeared with increasing severity of DR was 10.89 ± 7.98 in the first group, 12.25 ± 10.84 in the second group and 13.25 ± 10.66 in the third group. The average difference between the first and third groups was statistically significant (p = 0.014). Conclusions: In our study, the Framingham Risk Score increased significantly with more severe DR (p = 0.042). Our results are useful when considering the easily accessible identification of DR and that cardiovascular disease is one of the main causes of death worldwide. However, confirming the exact causal relationship based on our results is difficult because the study design was cross-sectional and additional studies are necessary.

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