Retinopathy as a predictor of other diabetic complications

被引：96

作者：

Abu El-Asrar A.M. ^{[1
]}

Al-Rubeaan K.A. ^{[2
]}

Al-Amro S.A. ^{[1
]}

Moharram O.A. ^{[2
]}

Kangave D. ^{[3
]}

机构：

[1] Department of Ophthalmology, College of Medicine, King Saud University, Riyadh

[2] Department of Medicine (Diabetes Centre), College of Medicine, King Saud University, Riyadh

[3] Research Centre, College of Medicine, King Saud University, Riyadh

来源：

International Ophthalmology | 2001年 / 24卷 / 1期

关键词：

Complications; Diabetes; Nephropathy; Neuropathy; Retinopathy; Stroke;

D O I：

10.1023/A:1014409829614

中图分类号：

学科分类号：

摘要：

Purpose: Early predictors of diabetic complications may aid in the prevention and/or management of these complications. The aim of this cross-sectional study was to determine the predictive value of retinopathy for the presence of other diabetic complications. Methods: The population studied comprised 648 patients with diabetes mellitus assessed by our service. There were 210 patients (32.4%) with insulin-dependent diabetes mellitus (IDDM), and 438 patients (67.6%) with non-insulin-dependent diabetes mellitus (NIDDM). Results: Univariate analyses revealed that retinopathy significantly predicted the presence of neuropathy (odds ratio [OR] = 2.23; 95% confidence interval [CI] = 1.56-3.18; p < 0.00l), nephropathy (OR = 5.68; 95% CI = 3.06-10.62; p < 0.00l), and cerebrovascular disease (OR = 6.6; 95% CI = 1.16-67.21; p = 0.0239) in the total group. Similar associations were observed both in subjects with IDDM and NIDDM. The associations between retinopathy severity level and the prevalence rate of nephropathy were significant in the total group (p = 0.0001), in patients with IDDM (p = 0.0113), and in patients with NIDDM (p = 0.01). In patients with mild to moderate non-proliferative retinopathy (NPDR), nephropathy was present in 17.2% of patients with IDDM, and in 11.4% of patients with NIDDM. In patients with severe NPDR, nephropathy was present in 23.3% in patients with IDDM, and in 11.8% of patients with NIDDM. In patients with proliferative retinopathy (PDR), nephropathy was present in 50% in patients with IDDM, and in 45.5% in patients with NIDDM. In multivariate logistic regression analyses, nephropathy was the only significant complication to be independently associated with retinopathy in patients with IDDM (OR = 8.02; 95% CI = 1.95-33), and in patients with NIDDM (OR = 2.48; 95% CI = 1.02-6.03). Conclusions: Retinopathy, especially the presence of PDR, is an independent predictor for nephropathy. The predictive value of retinopathy for nephropathy is stronger in patients with IDDM than in those with NIDDM. Ophthalmologists should refer patients with retinopathy for regular medical evaluations.

引用

页码：1 / 11

页数：10

共 34 条

[1] Weir G.C., Mathan D.M., Singer D.E., Standards of care for diabetes, Diabetes Care, 17, pp. 1514-1522, (1994)
[2] Klein R., Moss S.E., Visual impairment and diabetes, International Textbook of Diabetes Mellitus, 2, pp. 1373-1384, (1992)
[3] Photocoagulation treatment of proliferative diabetic retinopathy: Clinical application of Diabetic Retinopathy Study (DRS) findings: DRS report number 8, Ophthalmology, 88, pp. 583-600, (1981)
[4] Photocoagulation for diabetic macular edema: Early treatment diabetic retinopathy study report number 1, Arch Ophthalmol, 103, pp. 1796-1806, (1985)
[5] Gall M.A., Rossing P., Skott P., Damsbo P., Vaag A., Bech K., Et al., Prevalence of micro- and macroalbuminuria, arterial hypertension, retinopathy and large vessel disease in European type 2 (non-insulin-dependent) diabetic patients, Diabetologia, 34, pp. 655-661, (1991)
[6] Parving H.-H., Hommel E., Mathiesen E., Skott P., Edsberg B., Bahnsen M., Et al., Prevalence of microalbuminuria, arterial hypertension, retinopathy and neuropathy in patients with insulin dependent diabetes, Br Med J, 296, pp. 156-160, (1988)
[7] Savage S., Estacio R.O., Jeffers B., Schrier R.W., Urinary albumin excretion as a predictor of diabetic retinopathy, neuropathy, and cardiovascular disease in NIDDM, Diabetes Care, 19, pp. 1243-1248, (1996)
[8] Falkenberg M., Finnstrom K., Associations with retinopathy in type 2 diabetes: A population-based study in a Swedish rural area, Diabetic Med, 11, pp. 843-849, (1994)
[9] Estacio R.O., McFarling E., Biggerstaff S., Jeffers B.W., Johnson D., Schrier R.W., Overt albuminuria predicts diabetic retinopathy in Hispanics with NIDDM, Am J Kidney Dis, 31, pp. 947-953, (1998)
[10] Villar G., Garcia Y., Goicolea I., Vazquez J.A., Determinants of development of microalbuminuria in normotensive patients with type 1 and type 2 diabetes, Diabetes Metab, 25, pp. 246-254, (1999)

← 1 2 3 4 →