Presence of retinopathy and incident kidney and cardiovascular events in type 2 diabetes with normoalbuminuria - A post-hoc analysis of the PRIORITY randomized clinical trial

  • on the behalf of the PRIORITY Study Group
  • , Viktor Rotbain Curovic*
  • , Nete Tofte
  • , Morten Lindhardt
  • , Katarina Adamova
  • , Stephan J L Bakker
  • , Joachim Beige
  • , Joline W.J. Beulens
  • , Andreas L Birkenfeld
  • , Gemma Currie
  • , Christian Delles
  • , Ingo Dimos
  • , Lidmila Francová
  • , Marie Frimodt-Møller
  • , Peter Girman
  • , Rüdiger Göke
  • , Tine W. Hansen
  • , Tereza Havrdova
  • , Adriaan Kooy
  • , Gozewijnw D Laverman
  • Harald Mischak, Gerjan Navis, Giel Nijpels, Marina Noutsou, Alberto Ortiz, Aneliya Parvanova, Frederik Persson, John R Petrie, Piero L Ruggenenti, Femke Rutters, Ivan Rychlík, Justyna Siwy, Goce Spasovski, Marijn Speeckaert, Matias Trillini, Petra Zürbig, Heiko von der Leyen, Peter Rossing
*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftArtikelForskningpeer review

Abstract

AIMS: Baseline diabetic retinopathy (DR) and risk of development of microalbuminuria, kidney function decline, and cardiovascular events (CVEs) in type 2 diabetes.

METHODS: Post-hoc analysis of the PRIORITY study including 1758 persons with type 2 diabetes and normoalbuminuria followed for a median of 2.5 (IQR: 2.0-3.0) years. DR diagnosis included non-proliferative and proliferative abnormalities, macular oedema, or prior laser treatment. Cox models were fitted to investigate baseline DR presence with development of persistent microalbuminuria (urinary albumin-creatinine ratio > 30 mg/g); chronic kidney disease (CKD) G3 (eGFR <60 ml/min/1.73m2); and CVE. Models were adjusted for relevant risk factors.

RESULTS: At baseline, 304 (17.3 %) had DR. Compared to persons without DR, they were older (mean ± SD: 62.7 ± 7.7 vs 61.4 ± 8.3 years, p = 0.019), had longer diabetes duration (17.9 ± 8.4 vs. 10.6 ± 7.0 years, p < 0.001), and higher HbA1c (62 ± 13 vs. 56 ± 12 mmol/mol, p < 0.001). The adjusted hazard ratios of DR at baseline for development of microalbuminuria (n = 197), CKD (n = 166), and CVE (n = 64) were: 1.50 (95%CI: 1.07, 2.11), 0.87 (95%CI: 0.56, 1.34), and 2.61 (95%CI: 1.44, 4.72), compared to without DR.

CONCLUSIONS: Presence of DR in normoalbuminuric type 2 diabetes was associated with an increased risk of developing microalbuminuria and CVE, but not with kidney function decline.

OriginalsprogEngelsk
Artikelnummer108433
TidsskriftJournal of Diabetes and Its Complications
Vol/bind37
Udgave nummer4
Tidlig onlinedato18 feb. 2023
DOI
StatusUdgivet - apr. 2023

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