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Retinal Vascular Geometry Predicts Incident Renal Dysfunction in Young People With Type 1 Diabetes.
MedLine Citation:
PMID:  22250064     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVETo examine the relationship between retinal vascular geometry parameters and development of incident renal dysfunction in young people with type 1 diabetes.RESEARCH DESIGN AND METHODSA prospective cohort study of 511 adolescents with type 1 diabetes of at least 2 years duration, with normal albumin excretion rate (AER) and no retinopathy at baseline while attending an Australian tertiary-care hospital. AER was quantified using three overnight, timed urine specimen collections and early renal dysfunction was defined as AER >7.5 μg/min. Retinal vascular geometry (including length-to-diameter ratio [LDR] and simple tortuosity [ST]) was quantified from baseline retinal photographs. Generalized estimating equations were used to examine the relationship between incident renal dysfunction and baseline venular LDR and ST, adjusting for age, diabetes duration, glycated hemoglobin (A1C), blood pressure (BP), BMI, and cholesterol.RESULTSDiabetes duration at baseline was 4.8 (IQR 3.3-7.5) years. After a median 3.7 (2.3-5.7) years follow-up, 34% of participants developed incident renal dysfunction. In multivariate analysis, higher retinal venular LDR (odds ratio 1.7, 95% CI 1.2-2.4; quartile 4 vs. 1-3) and lower venular ST (1.6, 1.1-2.2; quartile 1 vs. 2-4) predicted incident renal dysfunction.CONCLUSIONSRetinal venular geometry independently predicted incident renal dysfunction in young people with type 1 diabetes. These noninvasive retinal measures may help to elucidate early mechanistic pathways for microvascular complications. Retinal venular geometry may be a useful tool to identify individuals at high risk of renal disease early in the course of diabetes.
Authors:
Paul Z Benitez-Aguirre; Muhammad Bayu Sasongko; Maria E Craig; Alicia J Jenkins; Janine Cusumano; Ning Cheung; Tien Yin Wong; Kim C Donaghue
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-16
Journal Detail:
Title:  Diabetes care     Volume:  -     ISSN:  1935-5548     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-1-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7805975     Medline TA:  Diabetes Care     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
The Children's Hospital at Westmead, Westmead, Australia.
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