Diabetic retinopathy as an independent predictor of subclinical cardiovascular disease: baseline results of the PRECISED study.
Aged
Biomarkers
/ analysis
Cardiovascular Diseases
/ diagnosis
Carotid Intima-Media Thickness
Case-Control Studies
Coronary Angiography
Diabetes Mellitus, Type 2
/ physiopathology
Diabetic Retinopathy
/ complications
Female
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Prognosis
Prospective Studies
Risk Factors
Spain
/ epidemiology
Tomography, X-Ray Computed
cardiovacsular disease(s)
retinopathy
type 2 diabetes
Journal
BMJ open diabetes research & care
ISSN: 2052-4897
Titre abrégé: BMJ Open Diabetes Res Care
Pays: England
ID NLM: 101641391
Informations de publication
Date de publication:
2019
2019
Historique:
received:
22
08
2019
revised:
01
11
2019
accepted:
11
11
2019
entrez:
8
1
2020
pubmed:
8
1
2020
medline:
12
9
2020
Statut:
epublish
Résumé
Detection of subclinical cardiovascular disease (CVD) has significant impact on the management of type 2 diabetes. We examined whether the assessment of diabetic retinopathy (DR) is useful for identifying patients at a higher risk of having silent CVD. Prospective case-control study comprising 200 type 2 diabetic subjects without history of clinical CVD and 60 age-matched non-diabetic subjects. The presence of subclinical CVD was examined using two parameters: (1) calcium coronary score (CACs); (2) composite of CACs >400 UA, carotid plaque ≥3 mm, carotid intima-media thickness ratio >1, or the presence of ECG changes suggestive of previous asymptomatic myocardial infarction. In addition, coronary angio-CT was performed. DR was assessed by slit-lamp biomicroscopy and retinography. Type 2 diabetic subjects presented higher CACs than non-diabetic control subjects (p<0.01). Age, male gender, and the presence of DR were independently related to CACs >400 (area under the receiver operating characteristic curve (AUROC) 0.76). In addition, an inverse relationship was observed between the degree of DR and CACs <10 AU. The variables independently associated with the composite measurement of subclinical CVD were age, diabetes duration, the glomerular filtration rate, microalbuminuria, and the presence of DR (AUROC 0.71). In addition, a relationship (p<0.01) was observed between the presence and degree of DR and coronary stenosis. The presence and degree of DR is independently associated with subclinical CVD in type 2 diabetic patients. Our results lead us to propose a rationalized screening for coronary artery disease in type 2 diabetes based on prioritizing patients with DR, particularly those with moderate-severe degree.
Identifiants
pubmed: 31908800
doi: 10.1136/bmjdrc-2019-000845
pii: bmjdrc-2019-000845
pmc: PMC6936469
doi:
Substances chimiques
Biomarkers
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e000845Informations de copyright
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
Korean J Fam Med. 2011 Mar;32(3):189-96
pubmed: 22745854
Diabet Med. 2008 Jan;25(1):45-50
pubmed: 18199131
Lancet Diabetes Endocrinol. 2013 Sep;1(1):71-8
pubmed: 24622269
N Engl J Med. 1998 Jul 23;339(4):229-34
pubmed: 9673301
Eur Heart J. 2008 Sep;29(18):2244-51
pubmed: 18573867
Diabetes Care. 2008 Feb;31(2):193-8
pubmed: 18024852
Clin Cardiol. 2017 Sep;40(9):752-758
pubmed: 28543093
N Engl J Med. 2010 Mar 4;362(9):800-11
pubmed: 20200384
Circulation. 2013 Mar 5;127(9):980-7
pubmed: 23362315
BMJ. 2013 Mar 25;346:f1654
pubmed: 23529983
JAMA. 2016 Dec 13;316(22):2402-2410
pubmed: 27898976
Front Immunol. 2018 Apr 17;9:706
pubmed: 29719532
J Am Coll Cardiol. 2004 May 5;43(9):1663-9
pubmed: 15120828
Ophthalmology. 2003 Sep;110(9):1677-82
pubmed: 13129861
Eur Heart J. 2003 Aug;24(15):1406-13
pubmed: 12909069
JAMA Cardiol. 2017 Dec 1;2(12):1332-1340
pubmed: 29117273
Eur Heart J. 2016 Aug 1;37(29):2315-2381
pubmed: 27222591
Cardiovasc Diabetol. 2015 Mar 18;14:33
pubmed: 25856787
Circulation. 2016 Jun 14;133(24):2459-502
pubmed: 27297342
J Am Heart Assoc. 2016 Jun 13;5(6):
pubmed: 27412899
JACC Cardiovasc Imaging. 2016 Feb;9(2):176-92
pubmed: 26846937
Diabetes Care. 2011 Oct;34(10):2285-90
pubmed: 21844289
J Am Coll Cardiol. 2010 Apr 13;55(15):1600-7
pubmed: 20378078
Diabetes Care. 2019 May;42(5):980-982
pubmed: 30862652
Nutr Metab Cardiovasc Dis. 2011 Apr;21(4):286-93
pubmed: 20163939
Circulation. 1990 Mar;81(3):899-906
pubmed: 2306839
Diabetes Care. 2017 Sep;40(9):1241-1248
pubmed: 28663384
Diabetes Care. 2007 Jul;30(7):1742-6
pubmed: 17389333
Cerebrovasc Dis. 2007;23(1):75-80
pubmed: 17108679
JACC Cardiovasc Imaging. 2012 Apr;5(4):358-66
pubmed: 22498324
Am J Cardiol. 2002 Nov 1;90(9):927-31
pubmed: 12398956
Diabetes Care. 2018 Jan;41(Suppl 1):S86-S104
pubmed: 29222380
JAMA Cardiol. 2017 Sep 1;2(9):986-994
pubmed: 28746709
Cardiovasc Diabetol. 2011 Jan 21;10:9
pubmed: 21255408
Am J Cardiol. 2016 Oct 1;118(7):944-9
pubmed: 27530826
Atherosclerosis. 2013 May;228(1):142-7
pubmed: 23477744
Lancet Diabetes Endocrinol. 2017 Jun;5(6):404-405
pubmed: 28456417
Circulation. 2015 Aug 25;132(8):691-718
pubmed: 26246173
Diabetes Obes Metab. 2019 Mar;21(3):467-478
pubmed: 30280465
Diabetes Care. 2011 May;34(5):1219-24
pubmed: 21398528
Eur Heart J. 2006 Mar;27(6):713-21
pubmed: 16497686
Diabetes Care. 2013 May;36(5):1266-71
pubmed: 23238658
J Am Coll Cardiol. 2010 Jun 8;55(23):2663-99
pubmed: 20513611
Lancet Diabetes Endocrinol. 2016 Jul;4(7):588-97
pubmed: 27216886