Tags

Type your tag names separated by a space and hit enter

Risk factors for development and progression of diabetic retinopathy in Dutch patients with type 1 diabetes mellitus.
Acta Ophthalmol. 2018 Aug; 96(5):459-464.AO

Abstract

PURPOSE

To investigate risk factors for the development and progression of diabetic retinopathy (DR) and long-term visual outcomes in Dutch patients with type 1 diabetes mellitus (T1DM).

METHODS

Cumulative incidences were calculated for DR, vision-threatening DR (VTDR), defined as (pre)proliferative DR and diabetic macular oedema, and best-corrected visual acuity (BCVA) <0.5 and <0.3 at the most recent eye examination. The following factors were assessed: duration of diabetes, age of onset of T1DM, gender, mean HbA1c, HbA1c variability (defined as coefficient of variation of five separate HbA1c measurements), mean arterial blood pressure, body mass index, albuminuria and lipid profile. We used multivariable Cox regression models to identify factors associated with DR development and progression to VTDR.

RESULTS

We found 25-year cumulative incidences of 63% for DR, 21% for VTDR, 2% for BCVA <0.5, and 1% for BCVA <0.3. Mean HbA1c (HR 1.023, p < 0.001), HbA1c variability (HR 1.054, p < 0.001), age of onset of T1DM (HR 1.024, p < 0.001), HDL cholesterol (HR 0.502, p = 0.002) and total cholesterol (HR 1.210, p = 0.029) showed an independent association with faster development of any form of DR. The mean HbA1c (HR 1.023, p < 0.001) and the presence of albuminuria (HR 2.940, p = 0.028) were associated with faster progression to VTDR.

CONCLUSION

These data show relatively low cumulative incidences of DR, VTDR and visual impairment. Higher mean HbA1c, HbA1c variability, age of onset of T1DM and total cholesterol were independently associated with the risk of DR development, and a protective association was found for HDL cholesterol in subjects with T1DM. Mean HbA1c and presence of albuminuria were associated with progression of DR.

Authors+Show Affiliations

Department of Ophthalmology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.Department of Ophthalmology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.Department of Ophthalmology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.Department of Ophthalmology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.Department of Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands.Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.Department of Ophthalmology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.Department of Ophthalmology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.Department of Ophthalmology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands. Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands. Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.Department of Ophthalmology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30188024

Citation

Schreur, Vivian, et al. "Risk Factors for Development and Progression of Diabetic Retinopathy in Dutch Patients With Type 1 Diabetes Mellitus." Acta Ophthalmologica, vol. 96, no. 5, 2018, pp. 459-464.
Schreur V, van Asten F, Ng H, et al. Risk factors for development and progression of diabetic retinopathy in Dutch patients with type 1 diabetes mellitus. Acta Ophthalmol. 2018;96(5):459-464.
Schreur, V., van Asten, F., Ng, H., Weeda, J., Groenewoud, J. M. M., Tack, C. J., Hoyng, C. B., de Jong, E. K., Klaver, C. C. W., & Jeroen Klevering, B. (2018). Risk factors for development and progression of diabetic retinopathy in Dutch patients with type 1 diabetes mellitus. Acta Ophthalmologica, 96(5), 459-464. https://doi.org/10.1111/aos.13815
Schreur V, et al. Risk Factors for Development and Progression of Diabetic Retinopathy in Dutch Patients With Type 1 Diabetes Mellitus. Acta Ophthalmol. 2018;96(5):459-464. PubMed PMID: 30188024.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors for development and progression of diabetic retinopathy in Dutch patients with type 1 diabetes mellitus. AU - Schreur,Vivian, AU - van Asten,Freekje, AU - Ng,Heijan, AU - Weeda,Jack, AU - Groenewoud,Joannes M M, AU - Tack,Cees J, AU - Hoyng,Carel B, AU - de Jong,Eiko K, AU - Klaver,Caroline C W, AU - Jeroen Klevering,B, PY - 2018/02/08/received PY - 2018/04/15/accepted PY - 2018/9/7/entrez PY - 2018/9/7/pubmed PY - 2018/9/22/medline KW - cumulative incidence KW - diabetic retinopathy KW - risk factors KW - type 1 diabetes mellitus KW - vision-threatening diabetic retinopathy SP - 459 EP - 464 JF - Acta ophthalmologica JO - Acta Ophthalmol VL - 96 IS - 5 N2 - PURPOSE: To investigate risk factors for the development and progression of diabetic retinopathy (DR) and long-term visual outcomes in Dutch patients with type 1 diabetes mellitus (T1DM). METHODS: Cumulative incidences were calculated for DR, vision-threatening DR (VTDR), defined as (pre)proliferative DR and diabetic macular oedema, and best-corrected visual acuity (BCVA) <0.5 and <0.3 at the most recent eye examination. The following factors were assessed: duration of diabetes, age of onset of T1DM, gender, mean HbA1c, HbA1c variability (defined as coefficient of variation of five separate HbA1c measurements), mean arterial blood pressure, body mass index, albuminuria and lipid profile. We used multivariable Cox regression models to identify factors associated with DR development and progression to VTDR. RESULTS: We found 25-year cumulative incidences of 63% for DR, 21% for VTDR, 2% for BCVA <0.5, and 1% for BCVA <0.3. Mean HbA1c (HR 1.023, p < 0.001), HbA1c variability (HR 1.054, p < 0.001), age of onset of T1DM (HR 1.024, p < 0.001), HDL cholesterol (HR 0.502, p = 0.002) and total cholesterol (HR 1.210, p = 0.029) showed an independent association with faster development of any form of DR. The mean HbA1c (HR 1.023, p < 0.001) and the presence of albuminuria (HR 2.940, p = 0.028) were associated with faster progression to VTDR. CONCLUSION: These data show relatively low cumulative incidences of DR, VTDR and visual impairment. Higher mean HbA1c, HbA1c variability, age of onset of T1DM and total cholesterol were independently associated with the risk of DR development, and a protective association was found for HDL cholesterol in subjects with T1DM. Mean HbA1c and presence of albuminuria were associated with progression of DR. SN - 1755-3768 UR - https://www.unboundmedicine.com/medline/citation/30188024/Risk_factors_for_development_and_progression_of_diabetic_retinopathy_in_Dutch_patients_with_type_1_diabetes_mellitus_ L2 - https://doi.org/10.1111/aos.13815 DB - PRIME DP - Unbound Medicine ER -