Subclinical atherosclerosis associates with diabetic retinopathy incidence: a prospective study

Fang, Qianhua; Xiang, Minqi; Shi, Juan; Zhou, Ying‐Guo; Peng, Ying; Wang, Shujie; Liu, Cong; Ji, Hong; Gu, Weiqiong; Wang, Weiqing; Zhang, Yifei

doi:10.1007/s00592-022-01897-w

Cited by 5 publications

(4 citation statements)

References 34 publications

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“…DKD was defined as an estimated glomerular filtration rate < 60 mL/min/1.73m 2 , a urinary albumin/creatinine ratio ≥ 3.39 mg/mmol, or both. The incidence of DR during follow-up in this study was defined as the onset of referable DR (moderate nonproliferative DR or worse) by fundus photography [ 31 ].…”

Section: Methodsmentioning

confidence: 99%

Impact of baseline and trajectory of the atherogenic index of plasma on incident diabetic kidney disease and retinopathy in participants with type 2 diabetes: a longitudinal cohort study

Zhang,

Liu,

Peng

et al. 2024

Lipids Health Dis

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Background Some studies have assessed the predictive role of the atherogenic index of plasma (AIP) for macrovascular diseases. This prospective investigation aimed to elucidate whether AIP is associated with diabetic kidney disease (DKD) and diabetic retinopathy (DR) incidence. Methods The data were extracted from 4831 participants, of whom 2943 and 3360 participants with type 2 diabetes (T2D) were included in the DKD and DR follow-up analyses, respectively. Cox regression models were performed to test the relationships of AIP value at baseline with the risk of incident DKD and DR. Group-based trajectory modelling was utilized to discern AIP trajectories during the follow-up period. Subsequently, logistic regressions were applied to ascertain the influence of AIP trajectories on the incidence of DKD and DR. Results During the follow-up period, 709 (24.1%) and 193 (5.7%) participants developed DKD and DR, respectively. The median (interquartile range) follow-up time was 24.2 (26.3) months for DKD and 25.7 (27.0) months for DR. According to the multivariate Cox regression models, baseline AIP was positively and linearly related to the occurrence of DKD, with a hazard ratio of 1.75 (95% confidence interval [CI] 1.36–2.26). Three distinct trajectories of AIP were identified throughout the follow-up time: Low (31.4%), Median (50.2%), and High (18.3%). Compared to participants with the Low AIP trajectory, those with High and Median AIP trajectories presented 117% (95% CI: 1.62–2.91) and 84% (95% CI 1.46–2.32) greater odds of developing DKD, respectively. However, neither baseline levels nor trajectories of AIP were shown to be related to DR after adjusting for confounding factors. Conclusions Baseline levels and trajectories of AIP were independently related to elevated DKD risk, indicating that AIP could be used as a predictor for identifying T2D participants at higher risk of DKD. No association between AIP and DR was detected.

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Section: Methodsmentioning

confidence: 99%

Impact of baseline and trajectory of the atherogenic index of plasma on incident diabetic kidney disease and retinopathy in participants with type 2 diabetes: a longitudinal cohort study

Zhang,

Liu,

Peng

et al. 2024

Lipids Health Dis

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“…All participants completed a standardized questionnaire and underwent comprehensive clinical and laboratory examinations at registration and follow-up visits, with data recorded in an MMC-specialized electronic medical data record system, as previously described [ 25 , 26 ]. Smoking status was defined as ‘ideal’ if the participants did not smoke or had quit smoking for more than 12 months.…”

Section: Methodsmentioning

confidence: 99%

Visit-to-visit HbA1c variability is associated with aortic stiffness progression in participants with type 2 diabetes

Fang

Shi

Zhang

et al. 2023

Cardiovasc Diabetol

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Background Glycemic variability plays an important role in the development of cardiovascular disease (CVD). This study aims to determine whether long-term visit-to-visit glycemic variability is associated with aortic stiffness progression in participants with type 2 diabetes (T2D). Methods Prospective data were obtained from 2115 T2D participants in the National Metabolic Management Center (MMC) from June 2017 to December 2022. Two brachial-ankle pulse wave velocity (ba-PWV) measurements were performed to assess aortic stiffness over a mean follow-up period of 2.6 years. A multivariate latent class growth mixed model was applied to identify trajectories of blood glucose. Logistic regression models were used to determine the odds ratio (OR) for aortic stiffness associated with glycemic variability evaluated by the coefficient of variation (CV), variability independent of the mean (VIM), average real variability (ARV), and successive variation (SV) of blood glucose. Results Four distinct trajectories of glycated hemoglobin (HbA1c) or fasting blood glucose (FBG) were identified. In the U-shape class of HbA1c and FBG, the adjusted ORs were 2.17 and 1.21 for having increased/persistently high ba-PWV, respectively. Additionally, HbA1c variability (CV, VIM, SV) was significantly associated with aortic stiffness progression, with ORs ranging from 1.20 to 1.24. Cross-tabulation analysis indicated that the third tertile of the HbA1c mean and VIM conferred a 78% (95% confidence interval [CI] 1.23–2.58) higher odds of aortic stiffness progression. Sensitivity analysis demonstrated that the SD of HbA1c and the highest HbA1c variability score (HVS) were significantly associated with the adverse outcomes independent of the mean of HbA1c during the follow-up. Conclusions Long-term visit-to-visit HbA1c variability was independently associated with aortic stiffness progression, suggesting that HbA1c variability was a strong predictor of subclinical atherosclerosis in T2D participants.

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“…Three self-reported options were available to assess sleep quality based on subjective evaluation: 1) good, 2) poor, and 3) requiring medication. The definition of ideal smoking status and alcohol consumption, as well as the standards for physical measurements, were detailed in our previously published studies ( 15 , 16 ). Blood pressure was measured after a minimum of 5 minutes of rest.…”

Section: Methodsmentioning

confidence: 99%

Effects of sleep duration and changes in body mass index on diabetic kidney disease: a prospective cohort study

Liu,

Zhang,

Wei

et al. 2023

Front. Endocrinol.

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AimsTo examine the associations of sleep duration and changes in BMI with the onset of diabetic kidney disease (DKD).Materials and methods2,959 participants with type 2 diabetes were divided into three groups based on sleep duration: short (<7 h/day), intermediate (7-9 h/day), or long (>9 h/day). Changes in BMI during follow-up were trisected into loss, stable, or gain groups. DKD was defined as either the urinary albumin/creatinine ratio (UACR) ≥ 3.39 mg/mmol or the estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m², or both. Cox regression models were used to assess hazard ratios (HRs) and 95% confidence intervals (CIs).ResultsDuring a mean follow-up of 2.3 years, DKD occurred in 613 participants (20.7%). A J-shaped curve was observed between sleep duration and DKD. Compared to intermediate sleep duration, long sleep duration was associated with higher risks of DKD (HR 1.47; 95% CI: 1.19-1.81). In the joint analyses, compared to participants with intermediate sleep duration and stable BMI, long sleep duration with BMI gain had the highest risks of DKD (HR 2.04; 95% CI: 1.48-2.83). In contrast, short or intermediate sleep duration accompanied by decrease in BMI was associated with a reduced risk of DKD, with HRs of 0.50 (95% CI: 0.31-0.82) and 0.61 (95% CI:0.47-0.80), respectively.ConclusionsLong sleep duration is significantly associated with an increased risk of DKD, which is further amplified by obesity or BMI gain. These findings suggest that both proper sleep duration and weight control are essential to preventing DKD.

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Subclinical atherosclerosis associates with diabetic retinopathy incidence: a prospective study

Cited by 5 publications

References 34 publications

Impact of baseline and trajectory of the atherogenic index of plasma on incident diabetic kidney disease and retinopathy in participants with type 2 diabetes: a longitudinal cohort study

Impact of baseline and trajectory of the atherogenic index of plasma on incident diabetic kidney disease and retinopathy in participants with type 2 diabetes: a longitudinal cohort study

Visit-to-visit HbA1c variability is associated with aortic stiffness progression in participants with type 2 diabetes

Effects of sleep duration and changes in body mass index on diabetic kidney disease: a prospective cohort study

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