Assessing Framingham cardiovascular risk scores in subjects with diabetes and their correlation with diabetic retinopathy

Damkondwar, Deepali R; Raman, Rajiv; Suganeswari, G; Kulothungan, Vaitheeswaran; Sharma, Tarun

doi:10.4103/0301-4738.91344

Cited by 16 publications

(11 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the MDRS 24-month cohort study, lower hemoglobin was associated with the presence of STDR at baseline (previously reported 14 ) but not with the progression of DR. Cross-sectional (but not cohort) studies have demonstrated an association between the presence of DR and anemia in India32, 33, 34 and China 35 . Potential confounders of the association between hemoglobin and retinopathy are socioeconomic and nutritional status and decreased erythropoietin production due to diabetic nephropathy.…”

Section: Discussionmentioning

confidence: 99%

First Prospective Cohort Study of Diabetic Retinopathy from Sub-Saharan Africa

et al. 2016

View full text Add to dashboard Cite

PurposeTo describe the prevalence, incidence, and progression of retinopathy and to report associations with demographic, clinical, and biochemical variables in people with diabetes in Southern Malawi.DesignProspective cohort study.ParticipantsSubjects were systematically sampled from 2 primary care diabetes clinics.MethodsWe performed the first prospective cohort study of diabetic retinopathy from Sub-Saharan Africa over 24 months. Visual acuity, glycemic control, blood pressure, human immunodeficiency virus (HIV) status, urine albumin-to-creatinine ratio, hemoglobin, and lipids were assessed. Retinopathy was graded at an accredited reading center using modified Wisconsin grading of 4-field mydriatic photographs.Main Outcome MeasuresIncidence of sight-threatening retinopathy and progression of retinopathy by 2 steps on the Liverpool Diabetic Eye Study Scale.ResultsA total of 357 subjects were recruited to the 24-month cohort study. At baseline, 13.4% of subjects were HIV positive and 15.1% were anemic. The 2-year incidence of sight-threatening diabetic retinopathy (STDR) for subjects with level 10 (no retinopathy), level 20 (background), and level 30 (preproliferative) retinopathy at baseline was 2.7% (95% confidence interval [CI], 0.1–5.3), 27.3% (95% CI, 16.4–38.2), and 25.0% (95% CI, 0–67.4), respectively. In a multivariate logistic analysis, 2-step progression of diabetic retinopathy was associated with glycosylated hemoglobin (odds ratio [OR], 1.27; 95% CI, 1.12–1.45), baseline grade of retinopathy (OR, 1.39; 95% CI, 1.02–1.91), and HIV infection (OR, 0.16; 95% CI, 0.03–0.78). At 2 years, 17 subjects (5.8%) lost ≥15 letters.ConclusionsIncidence of STDR was approximately 3 times that reported in recent European studies. The negative association of HIV infection with retinopathy progression is a new finding.

show abstract

Section: Discussionmentioning

confidence: 99%

First Prospective Cohort Study of Diabetic Retinopathy from Sub-Saharan Africa

et al. 2016

View full text Add to dashboard Cite

show abstract

“…In not stratifying HDL-C and confirmed by other authors [1]- [11] [31]- [41], traditional cardiovascular disease (CVD) risk factors such as smoking status, MS, high 10-year Framingham risk, insulin therapy, low intake of vegetables (Fumbwa leaves, beans), low education, low SES, elevated ApoB, HbA1c no control, and FPG no control were individually and significantly associated with DR in all T2DM patients.…”

Section: P-valuementioning

confidence: 79%

“…These paradoxical associations of a quantitative HDL-C trait could be dependent on genetic, ethnic, minority, and environmental (lifestyle changes: migration, urbanization, westernization, inappropriate diet, smoking, exaggerated physical activity, excessive alcohol intake) factors [41]- [52]. There are positive association between total cholesterol, the deficiency in cholesterol ester transfer protein (CETP), DR, poor control of HbA1c, insulin therapy, and increasing HDL-C levels in diabetic Africans [38] [46]- [48] people from developed countries [49]- [52] and Asians [8].…”

Section: Independent Determinants Of Dr By Stratifying Hdl-c Levelsmentioning

confidence: 99%

Associations of High Density Lipoprotein Cholesterol and Framingham Cardiovascular Risk with Diabetic Retinopathy in African Type 2 Diabetics

Longo-Mbenza¹,

Muaka²,

Gombet³

et al. 2014

WJCD

View full text Add to dashboard Cite

Objectives: To assess the associations of high density lipoprotein cholesterol (HDL-C) and Framingham cardiovascular (CVD) with diabetic retinopathy (DR). Methods: A cross-sectional study of random sample of 200 T2DM Central Africans. Sociobiographical, laboratory and eye examination main outcome measures were investigated using Tertiles of HDL-C (stratification = lowest < 40 mg/dL, normal or interdemiate = 40 -74.9 mg/dL, highest ≥ 75 mg/dL) and Framingham risk stratification (<10% and ≥10%) by logistic regression models. Results: Out of 200 T2DM patients, 120 (35.5%) had DR and out of DR patients, 116 (n = 96.7%) had VD. There was a significant Ushaped relationship between DR rates and HDL-C stratification. In the normal HDL-C group, elevated 8-hydroxydeoxyguanosine and 10-year Framingham risk > 10% were the significant independent determinants for DR. In the highest HDL-C group, smoking status and 10-year Framingham risk ≥ 10% were the significantly independent determinants for DR. In 10-year Framingham risk ≥ 10% group, smoking status, insulin resistance and increasing levels of HDL-C were the significantly independent determinants for DR. Conclusion: DR and VD remain a public health problem in T2DM Central Africans. Some Central Africans with DR and VD appear to have higher HDL-C than T2DM Central Africans without DR and VD. HDL-C in T2DM patients with DR, may be tightly * Corresponding author. B. Longo-Mbenza et al. 180controlled by genetic factors (black Bantu ethnicity) than the other lipoproteins as reported among Indians, African-Americans, and Japanese individuals. The most preventable environmental risk factors for DR were smoking status, global cardiovascular disease risk, insulin resistance and oxidative stress.

show abstract

“…Thus not all raised total serum HDLC are equally anti-atherogenic emphasizing HDLC particle composition rather than total HDLC, as an important determinant of its specific functional property (and role) as agreed by the expert clinical lipidologists. [1] Moreover, the inverse correlation between serum HDLC concentration and risk of CHD (Coronary Heart Disease) and decreased cardiovascular (CVD) risk with increasing HDLC levels have been known for years, particularly South Asians are not only notorious to have lower HDLC levels but also have a higher concentration of small, decreased-cardio-protective HDL particles. [34]…”

mentioning

confidence: 99%