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Objective: Glycosylated hemoglobin (HbA1c) has obvious clinical value in the diagnosis of diabetes, but the conclusions on the diagnostic value of diabetic retinopathy (DR) are not consistent. This study aims to comprehensively evaluate the accuracy of glycosylated hemoglobin in the diagnosis of diabetic retinopathy through the meta-analysis of diagnostic tests., Methods: Cochrane Library, Embase, PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), China Wanfang Database, Chinese Biomedical Literature Database (CBM) were searched until November, 2020. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was used to assess the quality of the included studies. The pooled sensitivity, specificity, positive likelihood ratio (+LR), negative likelihood ratio (-LR), diagnostic odds ratio (DOR) and areas under the receiver operating characteristic (ROC) curve were calculated by Stata 15.0 software., Results: After screening, 18 high-quality papers were included. The results of meta-analysis showed that the combined DOR = 18.19 (95% CI: 10.99-30.11), the sensitivity= 0.81 (95% CI): 0.75 ~ 0.87), specificity = 0.81 (95%CI: 0.72 ~ 0.87), +LR = 4.2 (95%CI: 2.95 ~ 6.00), -LR = 0.23 (95%CI: 0.17 ~ 0.31), and the area under the Summary ROC curve was 0.88 (95%CI:  0.85 ~ 0.90)., Conclusion: The overall accuracy of HbA1cC forin diagnosing diabetic retinopathy is good. As it is more stable than blood sugar and is not affected by meals, it may be a suitable indicator for diabetic retinopathy.

Aims: Epidemiological data on diabetic retinopathy (DR) in Chinese population is still rather scarce, and risk factors for diabetic retinopathy are inconsistent because of study designs, grading standards, and population samples., Materials and Methods: This hospital-based retrospective study included 1052 type 2 diabetes patients. Diabetic retinopathy was diagnosed by nonmydriatic fundus photography and/or fundus examination apparatus. Logistic regression analysis was performed to evaluate the risk of diabetic retinopathy., Results: A total of 352 (33.5% prevalence) subjects were diagnosed with diabetic retinopathy based on our population. The patients in the DR group not only had significantly higher hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), urinary microalbumin-creatinine ratio (ACR), and systolic blood pressure but also had higher follicle-stimulating hormone (FSH), luteinizing hormone (LH), and sex hormone-binding globulin (SHBG) levels compared to those in the non-DR group. Moreover, we confirmed that diabetes duration and HbA1c are strongly associated with DR risk. We also found that serum LH was an independent risk factor in male diabetic retinopathy patients (OR = 1.086, 95% CI 1.024-1.152), and the levels of LH were significantly associated with diabetic retinopathy prevalence ( P = 0.018)., Conclusions: Our study strengthens the argument that diabetes duration and HbA1c are risk factors for patients with DR. Additionally; we firstly confirmed that serum LH was an independent risk factor in male diabetic retinopathy patients., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2021 Qingmin Sun et al.)

Diabetic retinopathy is the main cause of visual impairment and blindness. The proliferative diabetic retinopathy at the severe stage of diabetic retinopathy is more harmful to vision and even leads to total blindness. To evaluate the visual acuity, central retinal thickness, and adverse reactions of various treatments for proliferative diabetic retinopathy through a systematic network meta-analysis. The relevant research published in English or Chinese from January 1, 2011, to February 1, 2021, was systematically searched by using PubMed, science network, EMBASE, MEDLINE, Cochrane Library, China National Knowledge Infrastructure, Wanfang, and other electronic databases. A total of 15 studies were selected, including 3,222 eyes of PDR patients. Our results show that in terms of visual score improvement, ranibizumab alone (69.90%) and laser + ranibizumab (67.90%) are the best. However, if the groups were grouped again according to the dose and times of ranibizumab injection, the results showed that 0.5 mg ranibizumab injection per month (58.0%) had the best effect on vision improvement. For the change of central retinal thickness, the thickness decreased the most after the laser combined with ranibizumab (96.5%). After the same subgroup analysis, the results were further refined into the best effect of laser combined with 0.3 mg ranibizumab per quarter (72.7%). In addition, our analysis of complications also showed that the overall incidence of adverse reactions of PRP (11.1 ± 12.4, %) was greater than that of ranibizumab (10.6 ± 13.0, %). However, more high-quality randomized controlled trials with longer follow-up using standard methods are still needed to verify the correlation. [ABSTRACT FROM AUTHOR]