Risk Factors for the Development of Retinopathy in Prediabetes and Type 2 Diabetes: The Diabetes Prevention Program Experience.

Autor:	White NH; Department of Pediatrics, Washington University in St. Louis School of Medicine, St. Louis, MO., Pan Q; The Biostatistics Center, Milken Institute School of Public Health, George Washington University, Rockville, MD., Knowler WC; National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ., Schroeder EB; Parkview Health, Fort Wayne, IN., Dabelea D; Colorado School of Public Health, Anschutz Medical Campus, Aurora, CO., Chew EY; Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, MD., Blodi B; Wisconsin Reading Center, Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI., Goldberg RB; Diabetes Research Institute, University of Miami Miller School of Medicine, Miami, FL., Pi-Sunyer X; Columbia University Irving Medical Center, New York, NY., Darwin C; Department of Medicine/Endocrinology Diabetes, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA., Schlögl M; University Clinic for Acute Geriatric Care, City Hospital Waid Zurich, Zurich, Switzerland., Nathan DM; Diabetes Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
Jazyk:	angličtina
Zdroj:	Diabetes care [Diabetes Care] 2022 Nov 01; Vol. 45 (11), pp. 2653-2661.
DOI:	10.2337/dc22-0860
Abstrakt:	Objective: To determine glycemic and nonglycemic risk factors that contribute to the presence of diabetic retinopathy (DR) before and after the onset of type 2 diabetes (T2D). Research Design and Methods: During the Diabetes Prevention Program (DPP) and DPP Outcome Study (DPPOS), we performed fundus photography over time in adults at high risk for developing T2D, including after they developed diabetes. Fundus photographs were graded using the Early Treatment Diabetic Retinopathy Study (ETDRS) grading system, with DR defined as typical lesions of DR (microaneurysms, exudates, hemorrhage, or worse) in either eye. Results: By DPPOS year 16 (∼20 years after random assignment into DPP), 24% of 1,614 participants who had developed T2D and 14% of 885 who remained without diabetes had DR. In univariate analyses, using results from across the entire duration of follow-up, American Indian race was associated with less frequent DR compared with non-Hispanic White (NHW) race, and higher HbA1c, fasting and 2-h plasma glucose levels during an oral glucose tolerance test, weight, and history of hypertension, dyslipidemia, and smoking, but not treatment group assignment, were associated with more frequent DR. On multivariate analysis, American Indian race was associated with less DR compared with NHW (odds ratio [OR] 0.36, 95% CI 0.20-0.66), and average HbA1c was associated with more DR (OR 1.92, 95% CI 1.46-1.74 per SD [0.7%] increase in HbA1c). Conclusions: DR may occur in adults with prediabetes and early in the course of T2D. HbA1c was an important risk factor for the development of DR across the entire glycemic range from prediabetes to T2D. (© 2022 by the American Diabetes Association.)
Databáze:	MEDLINE
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