Association of Diabetic Retinopathy With Stroke: A Systematic Review and Meta-Analysis

Hu, Kaiyan; Jiang, Mengyao; Zhou, Qi; Zeng, Weiting; Lan, Xuhong; Gao, Qianqian; Fan, Ming; Zhao, Li; Chen, Fei; Wu, Anhu; Tao, Gongcai; Mou, Chenghua; Ma, Bin

doi:10.3389/fneur.2021.626996

Cited by 20 publications

(15 citation statements)

References 47 publications

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“…Evidence suggests that subjects with diabetes and DR seem to be at a high risk of ischemic stroke, with a meta-analysis that included 19 observational cohort studies of 81,452 diabetic patients reporting that the presence of DR was associated with an increased risk of stroke (HR: 1.25, 95% CI: 1.12; 1.39). Subgroup analysis for the type of diabetes yielded a pooled HR of 1.29 and 95% CI: 1.10; 1.50 in T2DM ( 21 ). In a secondary analysis of patients enrolled in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Eye Study in an adjusted Cox regression model, DR was independently associated with incident stroke (HR:1.52, 95% CI:1.05; 2.20) ( 22 ).…”

Section: Discussionmentioning

confidence: 99%

“…We have extensive evidence that associates DR with other micro-and macrovascular complications of diabetes. Recently, it was reported that DR is associated with subclinical atherosclerosis (10)(11)(12)(13)(14), macrovascular comorbidities such as coronary disease (15)(16)(17)(18)(19)(20) and cerebrovascular accident (21)(22)(23)(24)(25)(26). Of interest, some studies have reported an association between cognitive impairment and the incidence of dementia [risk ratio (RR), 1.3; 95% confidence interval (CI), 1.27-1.58] (27,28), and the relation between DR and neurodegeneration diseases such as Parkinson's disease has been proposed but remains unclear (29).…”

Section: Introductionmentioning

confidence: 99%

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Diabetic retinopathy as a predictor of cardiovascular morbidity and mortality in subjects with type 2 diabetes

et al. 2022

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This study aimed to evaluate the predictive value of diabetic retinopathy (DR) and its stages with the incidence of major cardiovascular events and all-cause mortality in type 2 diabetes mellitus (T2DM) persons in our large primary healthcare database from Catalonia (Spain). A retrospective cohort study with pseudo-anonymized routinely collected health data from SIDIAP was conducted from 2008 to 2016. We calculated incidence rates of major cardiovascular events [coronary heart disease (CHD), stroke, or both—macrovascular events] and all-cause mortality for subjects with and without DR and for different stages of DR. The proportional hazards regression analysis was done to assess the probability of occurrence between DR and the study events. About 22,402 T2DM subjects with DR were identified in the database and 196,983 subjects without DR. During the follow-up period among the subjects with DR, we observed the highest incidence of all-cause mortally. In the second place were the macrovascular events among the subjects with DR. In the multivariable analysis, fully adjusted for DR, sex, age, body mass index (BMI), tobacco, duration of T2DM, an antiplatelet or antihypertensive drug, and HbA1c, we observed that subjects with any stage of DR had higher risks for all of the study events, except for stroke. We observed the highest probability of all-cause death events (adjusted hazard ratios, AHRs: 1.34, 95% CI: 1.28; 1.41). In conclusion, our results show that DR is related to CHD, macrovascular events, and all-cause mortality among persons with T2DM.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Diabetic retinopathy as a predictor of cardiovascular morbidity and mortality in subjects with type 2 diabetes

et al. 2022

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“…Neurology nursing is the key nursing method of stroke complicated with DM at present. It can intervene the patient according to their different condition, simultaneously observe patients' blood sugar level, effectively improve their limb function, and accelerate the process of disease rehabilitation [ 19 , 20 ]. The results showed that compared with the CG (6.93 ± 1.95, 12.79 ± 1.87, and 20.02 ± 5.68), the levels of fasting blood glucose, 2 h postprandial blood glucose, and urinary microalbumin in SG (6.01 ± 1.02, 11.18 ± 1.21, and 41.65 ± 6.07) were obviously better after treatment.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Rehabilitation Effect of Neurology Nursing on Stroke Patients with Diabetes Mellitus and Its Influence on Quality of Life and Negative Emotion Score

Yang

Niu

et al. 2022

Disease Markers

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Objective. To explore and analyze the rehabilitation effect of neurology nursing on stroke patients with diabetes mellitus (DM) and its influence on quality of life and negative emotion score. Methods. In this experiment, 110 stroke patients with DM diagnosed and treated in our hospital from 2018 to 2020 were randomly selected and assigned to the study group (SG) and the control group (CG) according to different nursing methods, with 55 cases in each group. In SG, they were given neurology nursing. In CG, they were given routine nursing. The rehabilitation efficacy, quality of life, and negative emotion scores were compared between the two groups. Results. Compared with the CG, the levels of fasting blood glucose, 2 h postprandial blood glucose, and urinary microalbumin in SG were obviously better after treatment. In SG, the proportion of patients with basic recovery and significant improvement after treatment was higher, and the proportion of patients without treatment effect was significantly lower. Overall, the nursing effect of the SG after treatment was better than that of the CG. There was no striking difference in the quality of life and Morisky scores between the two groups before nursing intervention ( P > 0.05 ), but the quality of life and Morisky scores of patients in SG were obviously higher than those in CG after nursing intervention. After nursing intervention, SAS and SDS scores of patients in SG were obviously lower than those of patients in CG, and patients in SG were less affected by negative emotions. Questionnaires were used to investigate the satisfaction of patients in both groups, and the results showed that the satisfaction of patients in SG was higher (all P < 0.05 ). Conclusion. Neurology nursing has better clinical efficacy for stroke patients with DM and has obvious rehabilitation effect. The quality of life and negative emotion score of patients are better, which is worthy of extensive clinical promotion and application.

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“…Some researches [ 31 ] have included 5 studies on DR in stroke risk when exploring the potential relationship between DR and the risk of all-cause mortality, stroke and heart failure, which revealed that DR was significantly associated with an increased risk of stroke compared with patients without DR [RR (Risk Ratio): 1.74; 95% CI, 1.35-2.24]. In a meta-analysis of 18 cohort studies, researchers [ 32 ] also concluded that the presence of DR was associated with an increased risk of stroke in patients with diabetes, with an RR of 2.29 (95% CI, 1.77-2.96; P < .0001), while no definitive results were obtained in patients with T1D.…”

Section: Discussionmentioning

confidence: 99%

Diabetic Retinopathy May Be a Predictor of Stroke in Patients With Diabetes Mellitus

Wang

Cao

Zhuang

et al. 2022

Journal of the Endocrine Society

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BACKGROUND To investigate a conclusive relationship between diabetic retinopathy (DR) and the risk of stroke, we performed a meta-analysis of the available relevant studies. METHODS After a systematic search of studies in electronic databases, we screened all studies reporting the risk of DR status and stroke incidence and calculated their odds ratios (ORs) and hazard ratios (HRs). The effects of type of diabetes and severity of DR were also considered for subgroup analysis. RESULTS We included a total of 19 studies involving 45,495 patients. A pooled HR=1.62 (1.28, 2.06) were found for the risk of DR and stroke in diabetic patients. In a subgroup analysis performed on the type of diabetes, the results showed a significant association between stroke incidence and DR status in patients with T2D (OR: 1.78; 95% CL: 1.53, 2.08), but this association was not conclusive in T1D (OR: 1.77; 95% CL: 0.48, 6.61). The results of the subgroup analysis with diabetes severity showed that both mild and moderate NPDR status and severe NPDR and worse status significantly increased the risk of stroke with HRs of 2,01 (1.45, 2.78) and 2.27 (1.52, 3.39), respectively. CONCLUSION DR status in diabetic patients is associated with an increased risk of stroke. This correlation was robust in patients with T2D, but uncertain in T1D. Based on this result, we have perhaps found the new factor for stroke management, so we analyzed the necessity and advantages of considering DR as a factor for stroke screening and risk management in our studies.

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Association of Diabetic Retinopathy With Stroke: A Systematic Review and Meta-Analysis

Cited by 20 publications

References 47 publications

Diabetic retinopathy as a predictor of cardiovascular morbidity and mortality in subjects with type 2 diabetes

Diabetic retinopathy as a predictor of cardiovascular morbidity and mortality in subjects with type 2 diabetes

Analysis of Rehabilitation Effect of Neurology Nursing on Stroke Patients with Diabetes Mellitus and Its Influence on Quality of Life and Negative Emotion Score

Diabetic Retinopathy May Be a Predictor of Stroke in Patients With Diabetes Mellitus

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