[[alternative]]Assessment of risk of diabetic retinopathy among different patient latent profile groups in a regional hospital.

[[abstract]]研究目的：利用潛在剖面分析（Latent Profile Analysis, LPA）方法將第二型糖尿病患者進行潛在類別分群，分析糖尿病患者發生視網膜病變之特性以及分析各潛在類組與糖尿病視網膜病變的相關性。研究方法：本研究屬於回溯型世代長期追蹤研究，資料來源為2012-2017年某區域醫院新陳代謝科糖尿病資料庫。擷取20歲以上並於新陳代謝科接受眼底鏡檢查之糖尿病患者，有效樣本數共5,513筆。運用潛在剖面分析方法探索糖尿病患者生化指標的潛在類組特性，並探討各類組發生視網膜病變之相關性。透過邏輯斯迴歸分析最適模型的各潛在類組特性與罹患糖尿病視網膜病變是否相關。研究結果：本研究結果發現年齡、糖尿病發病年數、腰圍、回診率、家族史、喝酒是顯著影響第二型糖尿病患者罹患糖尿病視網膜病變的相關因子。透過潛在剖面分析方法將糖尿病患者分成3組，分別為「自我控制最差組」、「自我控制中等組」以及「自我控制最佳組」。研究發現三組在人口特質的差異性，「自我控制最差組」患者的年齡最小（64.74歲）、糖尿病發病年數最短（10.81年）、有抽菸比例最高（26.8%）、有喝酒比例為最高（8.5%）、回診率最低（91%）；「自我控制中等組」患者中，女性比例最高（48.9%）、無抽菸比例最高（84.1%）、無喝酒比例最高（94.4%）、回診率最高（100%）；「自我控制最佳組」的患者年齡最大（67.39歲）、男性比例最高（69.2%）。經過邏輯斯迴歸分析後發現，「自我控制中等組」罹患糖尿病視網膜病變的機率是「自我控制最佳組」的0.720倍，「自我控制最差組」罹患糖尿病視網膜病變的機率是「自我控制最佳組」的2.655倍。結論：「自我控制最差組」患者罹患糖尿病視網膜病變的機率最高，其次是「自我控制最佳組」，最低是「自我控制中等組」。「自我控制最差組」患者抽菸、喝酒的比例也最多、糖尿病患者發病平均年數也最短、回診率也最低，因此建議該組糖尿病患者不僅要將生化指標控制好且需要避免抽菸與喝酒，更要定期至醫院回診，才能延緩得到視網膜病變的時間以及降低得到視網膜病變的機率。關鍵詞：第二型糖尿病、糖尿病視網膜病變、危險因子、潛在剖面分析[[abstract]]Objective: To explore subgroup characteristics and risks of diabetic retinopathy among patients with type 2 diabetes mellitus by using Latent Profile Analysis （LPA）.Method: Retrospective cohort study design was used. The dataset was collected from the department of metabolism of regional hospitals. Data of 5,513 individuals aged ≥20 years were analyzed. We used the logistic regression analysis to explore relationships between subgroups and diabetic retinopathy.Result: Age, type 2 diabetes mellitus duration, waistline, follow-up rate, family history, and drinking were risk factors significantly associated with diabetic retinopathy in patients with type 2 diabetes mellitus. Patients with type 2 diabetes mellitus were divided into three groups based on LPA: worst, medium, and best self-control groups. The three groups demonstrated differences in demographic characteristics. The worst self-control group patients were the youngest （age 64.74 years）; moreover, they had the shortest type 2 diabetes mellitus duration （i.e., 10.81 years）, the highest proportion of smokers （26.8%） and alcohol consumers （8.5%）, and the lowest follow-up rate （91%）. Medium self-control group patients had the highest proportion of women （48.9%） and follow-up rate （100%）, whereas the lowest proportion of smokers （84.1%） and alcohol consumers （94.4%）.Best self-control group patients had the highest proportion of men （69.2%） and were the oldest （age 67.39 years）. Logistic regression analysis revealed that medium and worst self-control groups patients were 0.720 and 2.655 times more likely to have diabetic retinopathy than were those in best self-control group, respectively.Conclusion: Worst self-control group patients had the highest probability to acquire diabetic retinopathy, followed by those in medium and best self-control groups. The worst self-control group patients had the highest proportion of smokers and alcohol consumers, but the lowest follow-up rate and shortest average retinopathy duration. Thus, patients with type 2 diabetes mellitus must control their biochemical indicators and avoid smoking and drinking to delay diabetic retinopathy development.Keywords: type 2 diabetes mellitus, diabetic retinopathy, risk factors, Latent Profile Analysi