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Glycosylated hemoglobin predicts the incidence and progression of diabetic retinopathy.

Abstract

The relationship between hyperglycemia, measured by glycosylated hemoglobin at the initial examination, and the four-year incidence and progression of diabetic retinopathy was examined in a population-based study in Wisconsin. Younger- (n = 891) and older-onset (n = 987) persons participating in baseline and follow-up examinations were included. Glycosylated hemoglobin was measured by microcolumn. Retinopathy was determined from stereoscopic fundus photographs. In the younger-onset group, comparing the highest with the lowest quartile of glycosylated hemoglobin, the relative risk for developing any diabetic retinopathy was 1.9; for proliferative retinopathy, 21.8; and for progression, 4.0. Among older-onset persons taking insulin, the corresponding relative risks were 1.9, 4.0, and 2.1. Among older-onset persons not taking insulin, relative risks were 4.0 for any retinopathy and 6.2 for progression. A positive relationship between incidence and progression of retinopathy and glycosylated hemoglobin remained after controlling for duration of diabetes, age, sex, and baseline retinopathy. These data suggest a strong and consistent relationship between hyperglycemia and incidence and progression of retinopathy.

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  • Authors+Show Affiliations

    ,

    Department of Ophthalmology, University of Wisconsin Medical School, Madison.

    , , ,

    Source

    JAMA 260:19 1988 Nov 18 pg 2864-71

    MeSH

    Adult
    Age Factors
    Cohort Studies
    Diabetes Mellitus, Type 1
    Diabetes Mellitus, Type 2
    Diabetic Retinopathy
    Female
    Follow-Up Studies
    Glycated Hemoglobin A
    Humans
    Hyperglycemia
    Male
    Models, Statistical
    Physical Examination
    Prognosis

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    3184351

    Citation

    Klein, R, et al. "Glycosylated Hemoglobin Predicts the Incidence and Progression of Diabetic Retinopathy." JAMA, vol. 260, no. 19, 1988, pp. 2864-71.
    Klein R, Klein BE, Moss SE, et al. Glycosylated hemoglobin predicts the incidence and progression of diabetic retinopathy. JAMA. 1988;260(19):2864-71.
    Klein, R., Klein, B. E., Moss, S. E., Davis, M. D., & DeMets, D. L. (1988). Glycosylated hemoglobin predicts the incidence and progression of diabetic retinopathy. JAMA, 260(19), pp. 2864-71.
    Klein R, et al. Glycosylated Hemoglobin Predicts the Incidence and Progression of Diabetic Retinopathy. JAMA. 1988 Nov 18;260(19):2864-71. PubMed PMID: 3184351.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Glycosylated hemoglobin predicts the incidence and progression of diabetic retinopathy. AU - Klein,R, AU - Klein,B E, AU - Moss,S E, AU - Davis,M D, AU - DeMets,D L, PY - 1988/11/18/pubmed PY - 1988/11/18/medline PY - 1988/11/18/entrez SP - 2864 EP - 71 JF - JAMA JO - JAMA VL - 260 IS - 19 N2 - The relationship between hyperglycemia, measured by glycosylated hemoglobin at the initial examination, and the four-year incidence and progression of diabetic retinopathy was examined in a population-based study in Wisconsin. Younger- (n = 891) and older-onset (n = 987) persons participating in baseline and follow-up examinations were included. Glycosylated hemoglobin was measured by microcolumn. Retinopathy was determined from stereoscopic fundus photographs. In the younger-onset group, comparing the highest with the lowest quartile of glycosylated hemoglobin, the relative risk for developing any diabetic retinopathy was 1.9; for proliferative retinopathy, 21.8; and for progression, 4.0. Among older-onset persons taking insulin, the corresponding relative risks were 1.9, 4.0, and 2.1. Among older-onset persons not taking insulin, relative risks were 4.0 for any retinopathy and 6.2 for progression. A positive relationship between incidence and progression of retinopathy and glycosylated hemoglobin remained after controlling for duration of diabetes, age, sex, and baseline retinopathy. These data suggest a strong and consistent relationship between hyperglycemia and incidence and progression of retinopathy. SN - 0098-7484 UR - https://www.unboundmedicine.com/medline/citation/3184351/full_citation L2 - https://jamanetwork.com/journals/jama/fullarticle/vol/260/pg/2864 DB - PRIME DP - Unbound Medicine ER -