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Risk factors for diabetic retinopathy in people with Type 2 diabetes: A case-control study in a UK primary care setting

Artikel i vetenskaplig tidskrift
Författare E. Martin-Merino
J. Fortuny
E. Rivero-Ferrer
Marcus Lind
L. A. Garcia-Rodriguez
Publicerad i Primary Care Diabetes
Volym 10
Nummer/häfte 4
Sidor 300-308
ISSN 1751-9918
Publiceringsår 2016
Publicerad vid Institutionen för medicin
Sidor 300-308
Språk en
Länkar dx.doi.org/10.1016/j.pcd.2016.01.00...
Ämnesord Diabetic retinopathy, Type 2 diabetes, Risk factors, Case-control study, Primary care, progression, insulin, complications, diagnosis, mellitus, Endocrinology & Metabolism, General & Internal Medicine
Ämneskategorier Endokrinologi

Sammanfattning

Aim: To identify risk factors of diabetic retinopathy (DR) among people with Type 2 diabetes mellitus in UK primary care. Methods: A case-control study nested in a cohort of incident Type 2 diabetes identified in The Health Improvement Network database from 2000 to 2007. Cases were people with DR (N=7735) and controls were a DR-free sample (N=9395). No age restrictions were applied. Adjusted odds ratios and 95% CIs were estimated. Results: 21% of DR cases were identified during the first semester after Type 2 diabetes diagnosis. After controlling for delay on the Type 2 diabetes diagnosis, the DR risk increased with the duration of diabetes. DR increased with a mean systolic BP >= 150 mmHg (1.18; 1.10-1.27), high alcohol consumption (1.34; 1.11-1.61), glycated haemoglobin (>= 75 to <86: 1.14; 1.00-1.31; >= 86 to <97 mmol/mol: 1.25; 1.07-1.45; >= 97 mmol/mol: 1.21; 1.07-1.37), microalbuminuria (1.16; 1.06-1.27), and retinal vein occlusion (2.47; 1.67-3.66). Glaucoma and retinal arterial occlusion showed an OR of 0.71 (0.60-0.84) and 0.63 (0.40-1.01), respectively. HDL >= 1.55 mmol/l (0.88; 0.80-0.98), high triglycerides (2.3-5.6 mmol/l: 0.90; 0.82-0.99; >5.6 mmol/l: 0.85; 0.64-1.13) or smoking (0.89; 0.81-0.97) had a slightly reduced DR risk. Users of hypoglycaemic agents had an increased DR risk. Conclusion: Some DR cases were identified near the diabetes diagnosis date suggesting that a delayed diabetes diagnosis is still common. Glaucoma, retinal arterial occlusion and high HDL levels were inversely associated with DR, while retinal vein occlusion, alcohol and other well-known risk factors were positively associated. (C) 2016 Published by Elsevier Ltd on behalf of Primary Care Diabetes Europe.

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