Tags

Type your tag names separated by a space and hit enter

Cardiovascular disease, mortality, and retinal microvascular characteristics in type 1 diabetes: Wisconsin epidemiologic study of diabetic retinopathy.
Arch Intern Med. 2004 Sep 27; 164(17):1917-24.AI

Abstract

BACKGROUND

Diabetic retinopathy and proteinuria, manifestations of microvascular abnormalities, occur early in the course of diabetes mellitus; in contrast, macrovascular cardiovascular complications usually occur later. Retinal vessel characteristics may be informative about risk of cardiovascular disease in persons with diabetes. We evaluated this in a longitudinal cohort study of persons with type 1 diabetes.

METHODS

The population consisted of persons with type 1 diabetes who were receiving care in 11 counties in Wisconsin. Subjects (n = 996) were examined at baseline (1980-1982), and 4, 10, 14, and 20 years later. Evaluations included medical history and measurements of height, weight, blood pressure, and glycosylated hemoglobin. Fundus photographs were graded for diabetic retinopathy at baseline, and the same photographs were graded later for the diameters of retinal blood vessels. At each examination, a history of cardiovascular disease events since the last examination (and prior to baseline) was obtained. Mortality was monitored yearly.

RESULTS

The 20-year age-adjusted cumulative incidences were 18.1% for angina, 14.8% for myocardial infarction, and 5.9% for stroke. Severity of diabetic retinopathy was associated with angina and stroke. Arteriovenous ratio was associated with myocardial infarction. Of 273 deaths, 176 involved heart disease. The severity of retinopathy and arteriovenous ratio was associated with heart disease mortality. Nephropathy was more informative about the cardiovascular end points than were the blood vessel characteristics.

CONCLUSIONS

Incidences of cardiovascular disease, including mortality, were common in people with type 1 diabetes during a 20-year interval. Retinal vascular characteristics were associated with these end points, but this association was confounded by nephropathy.

Authors+Show Affiliations

Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison 53726, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15451768

Citation

Klein, Barbara E K., et al. "Cardiovascular Disease, Mortality, and Retinal Microvascular Characteristics in Type 1 Diabetes: Wisconsin Epidemiologic Study of Diabetic Retinopathy." Archives of Internal Medicine, vol. 164, no. 17, 2004, pp. 1917-24.
Klein BE, Klein R, McBride PE, et al. Cardiovascular disease, mortality, and retinal microvascular characteristics in type 1 diabetes: Wisconsin epidemiologic study of diabetic retinopathy. Arch Intern Med. 2004;164(17):1917-24.
Klein, B. E., Klein, R., McBride, P. E., Cruickshanks, K. J., Palta, M., Knudtson, M. D., Moss, S. E., & Reinke, J. O. (2004). Cardiovascular disease, mortality, and retinal microvascular characteristics in type 1 diabetes: Wisconsin epidemiologic study of diabetic retinopathy. Archives of Internal Medicine, 164(17), 1917-24.
Klein BE, et al. Cardiovascular Disease, Mortality, and Retinal Microvascular Characteristics in Type 1 Diabetes: Wisconsin Epidemiologic Study of Diabetic Retinopathy. Arch Intern Med. 2004 Sep 27;164(17):1917-24. PubMed PMID: 15451768.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cardiovascular disease, mortality, and retinal microvascular characteristics in type 1 diabetes: Wisconsin epidemiologic study of diabetic retinopathy. AU - Klein,Barbara E K, AU - Klein,Ronald, AU - McBride,Patrick E, AU - Cruickshanks,Karen J, AU - Palta,Mari, AU - Knudtson,Michael D, AU - Moss,Scot E, AU - Reinke,Jennifer O, PY - 2004/9/29/pubmed PY - 2005/2/18/medline PY - 2004/9/29/entrez SP - 1917 EP - 24 JF - Archives of internal medicine JO - Arch Intern Med VL - 164 IS - 17 N2 - BACKGROUND: Diabetic retinopathy and proteinuria, manifestations of microvascular abnormalities, occur early in the course of diabetes mellitus; in contrast, macrovascular cardiovascular complications usually occur later. Retinal vessel characteristics may be informative about risk of cardiovascular disease in persons with diabetes. We evaluated this in a longitudinal cohort study of persons with type 1 diabetes. METHODS: The population consisted of persons with type 1 diabetes who were receiving care in 11 counties in Wisconsin. Subjects (n = 996) were examined at baseline (1980-1982), and 4, 10, 14, and 20 years later. Evaluations included medical history and measurements of height, weight, blood pressure, and glycosylated hemoglobin. Fundus photographs were graded for diabetic retinopathy at baseline, and the same photographs were graded later for the diameters of retinal blood vessels. At each examination, a history of cardiovascular disease events since the last examination (and prior to baseline) was obtained. Mortality was monitored yearly. RESULTS: The 20-year age-adjusted cumulative incidences were 18.1% for angina, 14.8% for myocardial infarction, and 5.9% for stroke. Severity of diabetic retinopathy was associated with angina and stroke. Arteriovenous ratio was associated with myocardial infarction. Of 273 deaths, 176 involved heart disease. The severity of retinopathy and arteriovenous ratio was associated with heart disease mortality. Nephropathy was more informative about the cardiovascular end points than were the blood vessel characteristics. CONCLUSIONS: Incidences of cardiovascular disease, including mortality, were common in people with type 1 diabetes during a 20-year interval. Retinal vascular characteristics were associated with these end points, but this association was confounded by nephropathy. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/15451768/Cardiovascular_disease_mortality_and_retinal_microvascular_characteristics_in_type_1_diabetes:_Wisconsin_epidemiologic_study_of_diabetic_retinopathy_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/archinte.164.17.1917 DB - PRIME DP - Unbound Medicine ER -