포도 섭취와 당뇨망막증의 연관성

Association between Grapes Intake and Diabetic Retinopathy: Inhibitory Effect of Resveratol on Diabetic Retinopathy

목적: 포도의 섭취와 당뇨망막증의 유병률과의 연관성을 알아보고자 하였다. 대상과 방법: 국민건강영양조사 2008‐2011 중에서 30세 이상이면서 당뇨병을 가지고 있는 1,555명을 대상으로 하였다. 포도 섭취 빈도는 식품 섭취 빈도 조사법을 기준으로 조사하여, 지난 1년간 평균 포도 섭취의 빈도를 10단계로 나누어 평가하였다. 당뇨망막증은산동 후에 7장의 표준망막사진을 얻어 분석하였다. 당뇨망막증을 Airlie House 분류체계에 따라서 전체 당뇨망막증, 증식 당뇨망막증,그리고 실명위험 당뇨망막증으로 나누어 분석하였다. 결과: 당뇨망막증은 16.9 ± 1.2%에서 발견되었다. 포도 섭취 빈도가 1단계 증가함에 따라 전체당뇨망막증은 14% 감소하였고(odds ratio [OR] 0.86, 95% confidence interval [CI] 0.75‐0.98), 증식 당뇨망막증은 35% 감소하였으며(OR 0.65, 95% CI 0.48‐0.88), 실명위험 당뇨망막증은 23% 감소하였다(OR 0.77, 95% CI 0.60‐0.99). 포도 섭취 빈도가 한 달에 1회 미만일 경우에 비하여 한 달에 2‐3회섭취할 경우에, 전체 당뇨망막증은 46% 감소하였고(OR 0.54, 95% CI 0.33‐0.89), 증식 당뇨망막증은 75% 감소하였으며(OR 0.25,95% CI 0.07‐0.81), 실명위험 당뇨망막증은 64% 감소하였다(OR 0.36, 95% CI 0.13‐0.95). 결론: 포도 섭취가 증가할수록 당뇨망막증의 유병률이 감소하였다.

Purpose: To evaluate the association between grape intake and diabetic retinopathy. Methods: A population-based cross-sectional study using a nation-wide, stratified, multistage, clustered sampling method included 1,555 subjects aged ≥30 years who participated in the Korean National Health and Nutritional Examination Survey 2008-2011. All participants performed standardized interviews, food frequency questionnaires (FFQ), and comprehensive ophthalmic examinations. Grape intake was evaluated by an FFQ using 10 intervals of average frequency of grape intake during the past year. Diabetic retinopathy (DR) was evaluated by 7 standard retinal fundus photographs after pharmacological pupil dilatation. DR was classified as any DR, proliferative DR, or vision-threatening DR by the modified Air House classification system. Results: The prevalence of diabetes was 16.9 ± 1.2%. As the grape intake frequency increases in FFQ, the odds ratio (OR) for any DR, proliferative DR, and vision-threatening DR were 0.86 (95% confidence interval [CI], 0.75-0.98), 0.65 (95% CI, 0.48-0.88), and 0.77 (95% CI, 0.60-0.99) respectively. Compared to the group with a grape intake of less than once per month, the OR for any DR, proliferative DR, and vision-threatening DR in the group with a grape intake of more than 2-3 times per month were 0.54 (95% CI 0.33-0.89), 0.25 (95% CI 0.07-0.81), 0.36 (95% CI 0.13-0.95), respectively. Conclusions: The intake of grapes was inversely associated with the prevalence of DR.