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Interactive effect of retinopathy and macroalbuminuria on all-cause mortality, cardiovascular and renal end points in Chinese patients with Type 2 diabetes mellitus.
Diabet Med. 2007 Jul; 24(7):741-6.DM

Abstract

AIMS

To examine the effect of albuminuria and retinopathy on the risk of cardiovascular and renal events, and all-cause mortality in patients with Type 2 diabetes.

METHODS

A post-hoc analysis of 4416 Chinese patients without macrovascular complications at baseline (age 57.6 +/- 13.3 years). Glomerular filtration rate (eGFR) was estimated by the abbreviated Modification of Diet in Renal Disease Study Group Formula, further adjusted for Chinese ethnicity. Clinical end points were all-cause mortality, cardiovascular events (heart failure or angina, myocardial infarction, lower limb amputation, re-vascularization procedures and stroke) and renal end points (reduction in eGFR by more than 50% or eGFR < 15 ml/min/1.73 m2 or death as a result of renal causes or need for dialysis).

RESULTS

Compared with individuals without complications, subjects with retinopathy and macroalbuminuria had higher rates of cardiovascular events (14.1 vs. 2.4%), renal events (40.0 vs. 0.8%) and death (9.3 vs. 1.7%, P < 0.001). For composite event of death, cardiovascular and renal events, the presence of retinopathy, microalbuminuria alone, macroalbuminuria alone, retinopathy with microalbuminuria or retinopathy with macroalbuminuria increased the risk [hazard ratio (95% CI)] by 1.61 (1.05 to 2.47; P = 0.04), 1.93 (1.38 to 2.69; P < 0.001), 4.34 (3.02 to 6.22; P < 0.001), 2.59 [1.76 to 3.81; P < 0.001) and 6.83 (4.89 to 9.55; P < 0.001) fold, respectively. The relative excess risk as a result of interaction between retinopathy and macroalbuminuria was 15.31, implying biological interaction in the development of renal events.

CONCLUSIONS

In Chinese patients with Type 2 diabetes, retinopathy interacts with macroalbuminuria to increase the risk of composite cardio-renal events.

Authors+Show Affiliations

Department of Medicine and Therapeutics, The Chinese University of Hong Kong, The Prince of Wales Hospital, NT, Hong Kong. ptong@cuhk.edu.hkNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo 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, Non-U.S. Gov't

Language

eng

PubMed ID

17403120

Citation

Tong, P C Y., et al. "Interactive Effect of Retinopathy and Macroalbuminuria On All-cause Mortality, Cardiovascular and Renal End Points in Chinese Patients With Type 2 Diabetes Mellitus." Diabetic Medicine : a Journal of the British Diabetic Association, vol. 24, no. 7, 2007, pp. 741-6.
Tong PC, Kong AP, So WY, et al. Interactive effect of retinopathy and macroalbuminuria on all-cause mortality, cardiovascular and renal end points in Chinese patients with Type 2 diabetes mellitus. Diabet Med. 2007;24(7):741-6.
Tong, P. C., Kong, A. P., So, W. Y., Yang, X., Ng, M. C., Ho, C. S., Ma, R. C., Ozaki, R., Ng, V., Chow, C. C., Lam, C. W., Chan, J. C., & Cockram, C. S. (2007). Interactive effect of retinopathy and macroalbuminuria on all-cause mortality, cardiovascular and renal end points in Chinese patients with Type 2 diabetes mellitus. Diabetic Medicine : a Journal of the British Diabetic Association, 24(7), 741-6.
Tong PC, et al. Interactive Effect of Retinopathy and Macroalbuminuria On All-cause Mortality, Cardiovascular and Renal End Points in Chinese Patients With Type 2 Diabetes Mellitus. Diabet Med. 2007;24(7):741-6. PubMed PMID: 17403120.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Interactive effect of retinopathy and macroalbuminuria on all-cause mortality, cardiovascular and renal end points in Chinese patients with Type 2 diabetes mellitus. AU - Tong,P C Y, AU - Kong,A P, AU - So,W Y, AU - Yang,X, AU - Ng,M C Y, AU - Ho,C S, AU - Ma,R C W, AU - Ozaki,R, AU - Ng,V, AU - Chow,C C, AU - Lam,C W K, AU - Chan,J C N, AU - Cockram,C S, Y1 - 2007/04/02/ PY - 2007/4/4/pubmed PY - 2007/11/8/medline PY - 2007/4/4/entrez SP - 741 EP - 6 JF - Diabetic medicine : a journal of the British Diabetic Association JO - Diabet Med VL - 24 IS - 7 N2 - AIMS: To examine the effect of albuminuria and retinopathy on the risk of cardiovascular and renal events, and all-cause mortality in patients with Type 2 diabetes. METHODS: A post-hoc analysis of 4416 Chinese patients without macrovascular complications at baseline (age 57.6 +/- 13.3 years). Glomerular filtration rate (eGFR) was estimated by the abbreviated Modification of Diet in Renal Disease Study Group Formula, further adjusted for Chinese ethnicity. Clinical end points were all-cause mortality, cardiovascular events (heart failure or angina, myocardial infarction, lower limb amputation, re-vascularization procedures and stroke) and renal end points (reduction in eGFR by more than 50% or eGFR < 15 ml/min/1.73 m2 or death as a result of renal causes or need for dialysis). RESULTS: Compared with individuals without complications, subjects with retinopathy and macroalbuminuria had higher rates of cardiovascular events (14.1 vs. 2.4%), renal events (40.0 vs. 0.8%) and death (9.3 vs. 1.7%, P < 0.001). For composite event of death, cardiovascular and renal events, the presence of retinopathy, microalbuminuria alone, macroalbuminuria alone, retinopathy with microalbuminuria or retinopathy with macroalbuminuria increased the risk [hazard ratio (95% CI)] by 1.61 (1.05 to 2.47; P = 0.04), 1.93 (1.38 to 2.69; P < 0.001), 4.34 (3.02 to 6.22; P < 0.001), 2.59 [1.76 to 3.81; P < 0.001) and 6.83 (4.89 to 9.55; P < 0.001) fold, respectively. The relative excess risk as a result of interaction between retinopathy and macroalbuminuria was 15.31, implying biological interaction in the development of renal events. CONCLUSIONS: In Chinese patients with Type 2 diabetes, retinopathy interacts with macroalbuminuria to increase the risk of composite cardio-renal events. SN - 0742-3071 UR - https://www.unboundmedicine.com/medline/citation/17403120/Interactive_effect_of_retinopathy_and_macroalbuminuria_on_all_cause_mortality_cardiovascular_and_renal_end_points_in_Chinese_patients_with_Type_2_diabetes_mellitus_ L2 - https://doi.org/10.1111/j.1464-5491.2007.02145.x DB - PRIME DP - Unbound Medicine ER -