ImportanceDiabetic retinopathy (DR) is a leading cause of blindness in the US, warranting updates on its prevalence and incidence in the setting of advancements in diabetic care over recent years.ObjectiveTo determine recent trends in DR prevalence stratified by baseline demographics to identify those populations at greater risk.Design, Setting, and ParticipantsThis was a cross-sectional epidemiologic evaluation conducted using deidentified data from the large federated TriNetX Analytics health research network composed of 56 health care organizations in the US. Patients from 2015 to 2022 who had an International Statistical Classification of Diseases and Related Health Problems, Tenth Revision code of type 1 DR (T1DR) or type 2 DR (T2DR) were included in this analysis. Patients were further stratified by age cohorts (20-29 years, 30-39 years, 40-49 years, 50-59 years, 60-69 years, and 70 years or older), race and ethnicity, and sex.Main Outcomes and MeasuresPrevalence per 100 000 patients and prevalence odds ratios (ORs) were calculated in Microsoft Excel and Posit (formerly RStudio).ResultsA total of 359 126 patients with T1DR or T2DR (mean [SD] age, 67 [14] years; 52% female) were included in this study between January 1, 2015, and December 21, 2022. T1DR increased in prevalence from 2015 to 2022, with T1DR increasing 1.15-fold affecting 70.4 patients per 100 000 in 2022. T2DR increased 1.07-fold affecting 461.7 patients per 100 000 in 2022. For T1DR, the cohort aged 20 to 39 years had the most substantial increase at 4.7 and 1.96 fold. Overall, White males had the largest prevalence ORs of T1DR at 1.41 (95% CI, 1.36-1.47) compared with White females (reference group). In T2DR, patients aged 20 to 39 years again had a 2.5- and 1.6-fold prevalence increase from 2015 to 2022. Regardless of age group, Hispanic males demonstrated larger prevalence OR at 4.08 (95% CI, 3.97-4.19) compared with White females followed by Hispanic females at 2.49 (95% CI, 2.42-2.56), Black males at 2.23 (95% CI, 2.17-2.29), and Black females at 2.00 (95% CI, 1.95-2.05).Conclusion and RelevanceThe prevalence of both T1DR and T2DR increased in this network from 2015 to 2022, with individuals aged 20 to 39 years showing large increases. Additionally, T2DR was associated with greater increases in both Hispanic and Black communities. These findings support DR screening in young adults and for T2DR interventions specifically designed for racial and ethnic minoritized patients most affected by disease. Future investigations are warranted to further investigate these trends among young adults.

中文翻译：

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总体医疗保健网络内糖尿病视网膜病变的纵向趋势和差异


重要性糖尿病视网膜病变 (DR) 是美国失明的主要原因，随着近年来糖尿病护理的进步，有必要对其患病率和发病率进行更新。目的确定按基线人口统计分层的 DR 患病率的最新趋势，以识别处于设计、设置和参与者这是一项横断面流行病学评估，使用来自美国 56 个医疗保健组织组成的大型联合 TriNetX Analytics 健康研究网络的去识别化数据进行。 2015 年至 2022 年期间接受过治疗的患者国际疾病和相关健康问题统计分类，第十修订版此分析中包括 1 型 DR (T1DR) 或 2 型 DR (T2DR) 的代码。患者按年龄组（20-29岁、30-39岁、40-49岁、50-59岁、60-69岁和70岁或以上）、种族和民族以及性别进一步分层。 主要结果和措施在 Microsoft Excel 和 Posit（以前称为 RStudio）中计算每 100 000 名患者的患病率和患病率比值比 (OR)。 结果共有 359 126 名 T1DR 或 T2DR 患者（平均 [SD] 年龄，67 [14] 岁；52% 为女性）于2015年1月1日至2022年12月21日期间被纳入本研究。从2015年到2022年，T1DR患病率增加，其中T1DR增加1.15倍，到2022年影响每10万人中70.4名患者。T2DR增加1.07倍，影响461.7名患者到 2022 年，每 10 万人中的患病率将增加。对于 T1DR，20 至 39 岁的人群增幅最大，分别为 4.7 倍和 1.96 倍。总体而言，与白人女性（参考组）相比，白人男性的 T1DR 患病率 OR 最大，为 1.41（95% CI，1.36-1.47）。在 T2DR 中，20 至 39 岁的患者再次出现 2.5 和 1。从 2015 年到 2022 年，患病率增加了 6 倍。无论年龄组如何，与白人女性相比，西班牙裔男性的患病率 OR 较高，为 4.08（95% CI，3.97-4.19），其次是西班牙裔女性，为 2.49（95% CI，2.42-2.56） ），黑人男性为 2.23（95% CI，2.17-2.29），黑人女性为 2.00（95% CI，1.95-2.05）。结论和相关性从 2015 年到 2022 年，该网络中 T1DR 和 T2DR 的患病率均有所增加，其中20岁至39岁的人群增幅较大。此外，T2DR 与西班牙裔和黑人社区的大幅增加有关。这些发现支持对年轻人进行 DR 筛查，以及专门为受疾病影响最严重的少数种族和族裔患者设计的 T2DR 干预措施。未来的调查有必要进一步调查年轻人中的这些趋势。