engleski

High prevalence of nonproliferative retinopathy in normoalbuminuric patients with type 1 diabetes

Retinopathy and nephropathy are most important microvascular complications in patients with diabetes. It is assumed that retinopathy and nephropathy occurs at the same time and that the severity of retinopathy parallels the presence and severity on nephropathy in diabetes mellitus and it has also been suggested that relationship between renal abnormalities and retinopathy are more frequent in patients with type 1 diabetes (T1DM) than type 2 diabetes. The aim of this study was to evaluate the prevalence of nonproliferative retinopathy (NPR) in normoalbuminuric T1DM. A total of 223 normoalbuminuric T1DM with normal or mildly decreased (estimated GFR > 60 mlmin- 11.73m2) renal function were included in this study (age 42±7 years, 120M/113F, BMI 25±4 kg/m2, HbA1c 7.0±1.4%, duration of diabetes 17±9 years, serum creatinine 70±12 umol/L, estimated GFR 106±15 mlmin-11.73m2, urinary albumin excretion rate (UAE) 9.8 (1.3-29.0 mg/24h). The majority of patients (70%) had no retinopathy while 67 (30%) had NPR. Patients with NPR compared to patients without retinopathy were older (49±8 vs 39±6 years, p<0.001), had longer duration of diabetes (24±9 vs 14 ± 8 years, p<0.001), higher BMI (25±4 vs 24±5 kg/m2, p=0.004), higher systolic blood pressure (130 (95-160) vs 120 (80-180) mmHg, p=0.03), higher resting heart rate (74 (44-111) vs 70 (51-98) beats/min, p=0.001), higher UAE (10.3 (1.3-29) vs 7.8 (2.3-25.5) mg/24h, p=0.006) and lower estimated GFR (101±17 vs 108±13 ml min-1 1.73m-2, p=0.001). The results of our study suggest high prevalence of NPR in normoalbuminuric T1DM. This points to the need for close monitoring of normoalbuminuric T1DM aimed at early detecting, preventing or limiting the progression of retinopathy.

type 1 diabetes; albuminuria; retinopathy

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