Rita Laiginhas1,2, Carolina Madeira3, Miguel Lopes1, João Sérgio Neves4,5, Margarida Barbosa1,6,7, Vitor Rosas3, Davide Carvalho4,8, Fernando Falcão-Reis3,5, Manuel Falcão9,10. 1. Faculty of Medicine, Porto University, Porto, Portugal. 2. Department of Ophthalmology, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal. 3. Department of Ophthalmology, Centro Hospitalar de São João, Porto, Portugal. 4. Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar de São João, Porto, Portugal. 5. Department of Surgery and Physiology, Faculty of Medicine of Porto University, Porto, Portugal. 6. Department of Anesthesiology, Centro Hospitalar de São João, Porto, Portugal. 7. I3S Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal. 8. Department of Endocrinology, Diabetes and Metabolism, Faculty of Medicine of Porto University, Porto, Portugal. 9. Department of Ophthalmology, Centro Hospitalar de São João, Porto, Portugal. falcao@med.up.pt. 10. Department of Surgery and Physiology, Faculty of Medicine of Porto University, Porto, Portugal. falcao@med.up.pt.
Abstract
PURPOSE: Age at diagnosis of type 1 diabetes (DM1) has been implied as an important factor associated with the development of the microvascular complications. Our aim was to identify factors associated with prevalent diabetic retinopathy (DR) and proliferative diabetic retinopathy (PDR) in DM1 people with early and late-onset. METHODS: We reviewed medical records from all DM1 people from the reference area of a tertiary center (about 340,000 persons). Univariate and multivariate logistic regression were used to assess the relationship between potential risk factors (sociodemographic, diabetes-related, co-morbidities, and laboratory parameters) and prevalent DR/PDR. We performed an analysis comparing patients diagnosed before (early-onset) and after (late-onset) 18 years of age. RESULTS: We included 140 patients in early-onset DM1 group and 169 in late-onset DM1 group. Longer duration of diabetes and HbA1c remained associated with prevalent DR in both groups after adjusting for potential risk factors. Nephropathy was associated with prevalent DR in the late-onset group but not in the early-onset group. Peripheral neuropathy remained associated with prevalent PDR when modeled together in the multivariate model. High BMI demonstrated a significative association with PDR in early but not in the late-onset DM1 group. CONCLUSIONS: Although previous reports suggest that age at DM1 diagnosis may have a role in DR prevalence, the risk factors for DR in early and late-onset DM1 were similar for both groups. Duration of disease and lifelong metabolic control were the major predictors for DR in both groups. Nephropathy was associated with DR in patients with late-onset disease. Neuropathy was associated with PDR occurrence in both groups. BMI was associated with PDR early-onset DM1 group.
PURPOSE: Age at diagnosis of type 1 diabetes (DM1) has been implied as an important factor associated with the development of the microvascular complications. Our aim was to identify factors associated with prevalent diabetic retinopathy (DR) and proliferative diabetic retinopathy (PDR) in DM1people with early and late-onset. METHODS: We reviewed medical records from all DM1people from the reference area of a tertiary center (about 340,000 persons). Univariate and multivariate logistic regression were used to assess the relationship between potential risk factors (sociodemographic, diabetes-related, co-morbidities, and laboratory parameters) and prevalent DR/PDR. We performed an analysis comparing patients diagnosed before (early-onset) and after (late-onset) 18 years of age. RESULTS: We included 140 patients in early-onset DM1 group and 169 in late-onset DM1 group. Longer duration of diabetes and HbA1c remained associated with prevalent DR in both groups after adjusting for potential risk factors. Nephropathy was associated with prevalent DR in the late-onset group but not in the early-onset group. Peripheral neuropathy remained associated with prevalent PDR when modeled together in the multivariate model. High BMI demonstrated a significative association with PDR in early but not in the late-onset DM1 group. CONCLUSIONS: Although previous reports suggest that age at DM1 diagnosis may have a role in DR prevalence, the risk factors for DR in early and late-onset DM1 were similar for both groups. Duration of disease and lifelong metabolic control were the major predictors for DR in both groups. Nephropathy was associated with DR in patients with late-onset disease. Neuropathy was associated with PDR occurrence in both groups. BMI was associated with PDR early-onset DM1 group.
Authors: Barbara E K Klein; Kayla L Horak; Kristine E Lee; Stacy M Meuer; Michael D Abramoff; Elsayed Z Soliman; Mary Rechek; Ronald Klein Journal: Ophthalmic Epidemiol Date: 2018-07-09 Impact factor: 1.648
Authors: Luis Forga; María José Goñi; Berta Ibáñez; Koldo Cambra; Marta García-Mouriz; Ana Iriarte Journal: J Diabetes Res Date: 2016-04-26 Impact factor: 4.011
Authors: Nicholas J Thomas; Samuel E Jones; Michael N Weedon; Beverley M Shields; Richard A Oram; Andrew T Hattersley Journal: Lancet Diabetes Endocrinol Date: 2017-11-30 Impact factor: 44.867