|
 |
|
|||||||
|
|||||||||
Diabetes Care 31:708-713, 2008
DOI: 10.2337/dc07-1657
© 2008 by the American Diabetes Association
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Epidemiology/Health Services Research |
Retinal Vascular Lesions in Patients of Caucasian and Asian Origin With Type 2 Diabetes
Baseline results from the ADVANCE Retinal Measurements (AdRem) study
1 Department of Epidemiology, University Medical Center Groningen, University of Groningen, the Netherlands
2 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
3 Cardiovascular Sciences Research Group, University of Manchester and Royal Infirmary, Manchester, U.K.
4 International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, U.K.
5 Molecular and Cellular Therapeutics and RCSI Research Institute, Royal College of Surgeons in Ireland, Dublin, Ireland
6 Department of Endocrinology, Chinese PLA General Hospital, Beijing, China
7 The George Institute for International Health, University of Sydney, Sydney, Australia
8 Departments of Ophthalmology and Epidemiology & Biostatistics, Erasmus Medical Center, Rotterdam, the Netherlands
Address correspondence and reprint requests to Prof. R.P. Stolk, Department of Epidemiology, University Medical Center Groningen, P.O. Box 30.001, 9700RB Groningen, Netherlands. E-mail: r.p.stolk{at}epi.umcg.nl
OBJECTIVE—The objective of this study was to describe prevalent vascular retinal lesions among patients with type 2 diabetes enrolled in the ADVANCE Retinal Measurements (AdRem) study, a substudy of the Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation (ADVANCE) trial.
RESEARCH DESIGN AND METHODS—Seven-field stereoscopic photographs of both eyes were obtained at the baseline assessment of the ADVANCE trial. All photographs were graded in a central reading center. Gradable retinal images were received from 1,605 patients.
RESULTS—The number of patients with any retinopathy (Early Treatment of Diabetic Retinopathy Study [ETDRS] score 
20) was 645 (40.2% [95% CI 37.8–42.6]); of these, 35 (2.2% [1.6–3.0]) had severe diabetic retinopathy (ETDRS score 50). Focal arterial narrowing, venous beading, and arteriovenous nicking were present in 3.8, 5.1, and 9.8% of participants, respectively. Among participants included in this study, Chinese and South-Asian patients had more retinopathy than Caucasians, as defined both by ETDRS score (49.4, 46.0, and 31.3%, respectively; P < 0.001, adjusted for age, sex, A1C, systolic blood pressure, and duration of diabetes) and specific vascular lesions (e.g., arteriovenous nicking 12.3, 8.5, and 7.5%, respectively; adjusted P < 0.005). A1C, duration of diabetes, and systolic blood pressure were similarly associated with increased retinal lesions in Chinese, South-Asian, and Caucasian patients.
CONCLUSIONS—Using a sensitive diagnostic procedure, more than one-third of patients with type 2 diabetes enrolled in the AdRem study had retinal lesions at baseline. Despite differences in prevalence and severity of retinopathy among Chinese, South-Asian, and Caucasian patients included in this study, the cross-sectional associations among established risk factors for retinopathy and retinal lesions were similar across ethnic groups.
Abbreviations: AdRem, Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation Retinal Measurements • ADVANCE, Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation • ETDRS, Early Treatment of Diabetic Retinopathy Study • UKPDS, United Kingdom Prospective Diabetes Study
CiteULike 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| Diabetes | Diabetes Care | Clinical Diabetes | Diabetes Spectrum |