文献类型：期刊文献

英文题名：Inverted U-shaped relationship between HbA1c and diabetic retinopathy in diabetic patients: a cross-sectional study

作者：Ling, Juan[1,2];Xie, ZhuoLin[3];Chen, XiaoJie[1,2];Ling, Di[4];Chen, XingLin[5,6];Luo, XiangXia[3]

第一作者：Ling, Juan

通信作者：Luo, XX[1]

机构：[1]Gansu Univ Chinese Med, Clin Coll Chinese Med, Lanzhou 730030, Gansu, Peoples R China;[2]Gansu Prov Hosp, Lanzhou 730030, Peoples R China;[3]Gansu Prov Hosp TCM, Lanzhou 730050, Gansu Prov, Peoples R China;[4]Third Peoples Hosp Gansu Prov, Lanzhou 730050, Gansu Prov, Peoples R China;[5]Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Dept Geriatr, Wuhan, Peoples R China;[6]X&Y Solut Inc, Dept Epidemiol & Biostat, Empower U, Boston, MA USA

第一机构：甘肃中医药大学

通信机构：[1]corresponding author), Gansu Prov Hosp TCM, Lanzhou 730050, Gansu Prov, Peoples R China.

年份：2025

卷号：25

期号：1

外文期刊名：BMC OPHTHALMOLOGY

收录：;Scopus(收录号：2-s2.0-105005077855);WOS:【SCI-EXPANDED(收录号:WOS:001495017600002)】；

基金：The authors sincerely thank all patients and their families for their support and participation in this study.

语种：英文

外文关键词：HbA1c; Diabetic retinopathy; Inverted U-Shaped Relationship; Cross-Sectional

摘要：BackgroundDiabetic retinopathy (DR) is a leading cause of blindness among adults with diabetes. Glycated hemoglobin A1C (HbA1C) is a critical biomarker for long-term glycemic control and has been closely associated with the risk of developing DR. However, the relationship between HbA1C and DR remains complex and multifaceted, with limited research exploring the nonlinear aspects of this association. This study aims to investigate the nonlinear relationship between HbA1C and DR, providing insights into their association and informing clinical interventions.ObjectiveMany studies have indicated that HbA1C is positively correlated with DR. However, although elevated HbA1C is common in patients with DR, its relationship with DR remains controversial. Our study aimed to investigate the nonlinear relationship between HbA1c and DR, thereby accurately elucidating their association and providing a basis for clinical interventions.MethodsThis study is the second analysis based on a cross-sectional studv. A total of 2,001 patients with type 2 Diabetes Mellitus (T2DM) visited the diabetic clinic in the Internal Medicine outpatient departments of two hospitals in southern Taiwan between April 2002 and November 2004 were included in this analysis. Demographic and clinical data were collected, and HbA1c levels were measured. The association between HbA1c and DR was analyzed using multivariate logistic regression, adjusting for potential confounders, and the potential nonlinear correlation was explored with a smooth curve fitting approach.ResultsThe fully-adjusted model showed that HbA1c positively correlated with DR (OR:1.13, 95%CI: 1.05-1.22). However, an inverted U-shaped association between them was observed by applying the smooth curve fitted method. The inflection point of HbA1c (9.4%) was calculated by utilizing the two-piecewise logistic regression model. In the subgroup analysis, the inverted U-shaped nonlinear correlation between HbA1c and DR was also found in age, sex and BMI.ConclusionsHbA1C and DR have an inverted U-shaped relationship, with a peak at an HbA1C of 9.4% in the early phase of DR. After this peak, HbA1C decreases as DR increases. These results have crucial implications for DR patients. The findings also offer insights for public health policy, highlighting the necessity of regular screening and intervention for diabetic patients. Future research should further explore the mechanisms linking HbA1c to DR and consider individualized management strategies for different populations to effectively mitigate the burden of DR.