Diabetic retinopathy as an independent marker of cardiovascular disease in type 1 diabetes: Results from a nationwide longitudinal matched case-cohort study.

Autor: Mabala DS; Department of Ophthalmology, Odense University Hospital, Odense, Denmark.; Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Stokholm L; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.; Department of Clinical Research, Research Unit OPEN, University of Southern Denmark, Odense, Denmark., Andersen N; Organization of Danish Practicing Ophthalmologists, Copenhagen, Denmark., Andresen J; Organization of Danish Practicing Ophthalmologists, Copenhagen, Denmark., Bek T; Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark., Heegaard S; Department of Ophthalmology, Rigshospitalet-Glostrup, Copenhagen, Denmark., Hajari J; Department of Ophthalmology, Rigshospitalet-Glostrup, Copenhagen, Denmark., Højlund K; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.; Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark., Kawasaki R; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.; Division of Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan., Laugesen CS; Department of Ophthalmology, Zealand University Hospital Roskilde, Roskilde, Denmark., Möller S; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.; Department of Clinical Research, Research Unit OPEN, University of Southern Denmark, Odense, Denmark., Pedersen FN; Department of Ophthalmology, Odense University Hospital, Odense, Denmark.; Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Schielke KC; Department of Ophthalmology, Aalborg University Hospital, Aalborg, Denmark., Thykjær AS; Department of Ophthalmology, Odense University Hospital, Odense, Denmark.; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.; Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark., Grauslund J; Department of Ophthalmology, Odense University Hospital, Odense, Denmark.; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.; Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark.
Jazyk: angličtina
Zdroj: Acta ophthalmologica [Acta Ophthalmol] 2024 Sep; Vol. 102 (6), pp. 635-642. Date of Electronic Publication: 2024 Feb 12.
DOI: 10.1111/aos.16653
Abstrakt: Purpose: To investigate diabetic retinopathy (DR) as a potential marker of cardiovascular disease (CVD) in adults with type 1 diabetes attending the Danish DR-screening programme and non-diabetes adults.
Methods: In this registry-based matched case-cohort study, we identified 16 547 adults with type 1 diabetes, who were registered in the Danish Registry of Diabetic Retinopathy (DiaBase). Each case was age- and sex-matched by five non-diabetes individuals (n = 82 399), and odds ratios (ORs) and hazard ratios (HRs) were estimated for incident and upcoming CVD in multivariable models.
Results: Adults with type 1 diabetes (median age 44.5 years, 57.6% male) were more likely to have prevalent CVD (OR 1.29; 95% CI, 1.20-1.38) and to develop CVD within 5 years (HR 1.19; 95% CI, 1.08-1.30) as compared to non-diabetes control. However, adults without DR were less likely to develop CVD (HR 0.84; 95% CI, 0.72-0.97) compared to the reference population. For adults with type 1 diabetes, there was an increasing risk for incident CVD for increasing levels of DR (HR 1.33, 1.95, 1.71 and 2.39 for DR-levels 1-4, respectively). Patients with CVD at the time of the first screening had a higher risk to develop DR during follow-up (HR 1.23; 95% CI, 1.02-1.49).
Conclusion: In a nationwide matched case-cohort study adjusted for potential confounders, DR was identified as an independent marker of prevalent and incident CVD in type 1 diabetes with increasing risk demonstrated for higher levels of DR. Likewise, CVD also independently predicted the risk of incident DR.
(© 2024 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.)
Databáze: MEDLINE
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