Naslov
Risk factors for development and progression of nonproliferative retinopathy in normoalbuminuric patients with type 1 diabetes

Autori
Bulum, Tomislav ; Blaslov, Kristina ; Duvnjak, Lea

Izvornik
Diabetes research and clinical practice (0168-8227) 106 (2014), 3; 555-559

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
type 1 diabetes; retinopathy; microvascular complications; albuminuria

Sažetak
Previous studies have reported that retinopathy might be present already in normoalbuminuric state in patients with type 1 diabetes mellitus (T1DM). The aim of this study was to evaluate the risk factors for development and progression of nonproliferative retinopathy (NPR) in normoalbuminuric T1DM. A total of 223 T1DM with normal renal function and normoalbuminuria were included in this study and followed for 48 months. Photodocumented retinopathy status was made according to the EURODIAB protocol. Urinary albumin excretion rate (UAE) was measured from at least two 24-h urine samples. The possible risk factors for development or progression of NPR were examined in backward stepwise Cox's multiple regression analysis. The majority of patients (70%) had no retinopathy while 67 (30%) had NPR at baseline. Patients with NPR were older, had longer duration of diabetes, higher systolic blood pressure, BMI, resting heart rate, UAE and lower estimated glomerular filtration rate (p≤0.04 for all). After 48 months twenty-four patients (10.7%) developed NPR or progressed to proliferative retinopathy. Systolic blood pressure (HR 1.03, CI 1.01-1.05, p=0.02), UAE (HR 1.14, CI 1.07-1.21, p<0.001), and resting heart rate (HR 1.05, CI 1.01-1.09, p=0.006) were significantly associated with development or progression of NPR. Our results suggest that retinopathy is present and may progress in T1DM even when coexisting renal disease is excluded. Normoalbuminuric T1DM requires close monitoring for the early detection of retinopathy, especially if they have a higher UAE, systolic blood pressure and resting heart rate.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA