Proliferative diabetic retinopathy is associated with microalbuminuria in patients with type 2 diabetes
Diabetic retinopathy is one of the leading causes of blindness in working-age individuals. Diabetic patients with proteinuria or those on dialysis usually present severe forms of diabetic retinopathy, but the association of diabetic retinopathy with early stages of diabetic nephropathy has not been...
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| Format: | Article |
| Language: | English |
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Associação Brasileira de Divulgação Científica
2006-08-01
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| Series: | Brazilian Journal of Medical and Biological Research |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2006000800006 |
| _version_ | 1819141762527002624 |
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| author | M.C. Boelter J.L. Gross L.H. Canani L.A. Costa H.R. Lisboa G.S. Três J. Lavinsky M.J. Azevedo |
| author_facet | M.C. Boelter J.L. Gross L.H. Canani L.A. Costa H.R. Lisboa G.S. Três J. Lavinsky M.J. Azevedo |
| author_sort | M.C. Boelter |
| collection | DOAJ |
| description | Diabetic retinopathy is one of the leading causes of blindness in working-age individuals. Diabetic patients with proteinuria or those on dialysis usually present severe forms of diabetic retinopathy, but the association of diabetic retinopathy with early stages of diabetic nephropathy has not been entirely established. A cross-sectional study was conducted on 1214 type 2 diabetic patients to determine whether microalbuminuria is associated with proliferative diabetic retinopathy in these patients. Patients were evaluated by direct and indirect ophthalmoscopy and grouped according to the presence or absence of proliferative diabetic retinopathy. The agreement of diabetic retinopathy classification performed by ophthalmoscopy and by stereoscopic color fundus photographs was 95.1% (kappa = 0.735; P < 0.001). Demographic information, smoking history, anthropometric and blood pressure measurements, glycemic and lipid profile, and urinary albumin were evaluated. On multiple regression analysis, diabetic nephropathy (OR = 5.18, 95% CI = 2.91-9.22, P < 0.001), insulin use (OR = 2.52, 95% CI = 1.47-4.31, P = 0.001) and diabetes duration (OR = 1.04, 95% CI = 1.01-1.07, P = 0.011) were positively associated with proliferative diabetic retinopathy, and body mass index (OR = 0.90, 95% CI = 0.86-0.96, P < 0.001) was negatively associated with it. When patients with macroalbuminuria and on dialysis were excluded, microalbuminuria (OR = 3.3, 95% CI = 1.56-6.98, P = 0.002) remained associated with proliferative diabetic retinopathy. Therefore, type 2 diabetic patients with proliferative diabetic retinopathy more often presented renal involvement, including urinary albumin excretion within the microalbuminuria range. Therefore, all patients with proliferative diabetic retinopathy should undergo an evaluation of renal function including urinary albumin measurements. |
| first_indexed | 2024-12-22T11:59:36Z |
| format | Article |
| id | doaj.art-977fbe0d2f3644ceab4b541ac0e7dfea |
| institution | Directory Open Access Journal |
| issn | 0100-879X 1414-431X |
| language | English |
| last_indexed | 2024-12-22T11:59:36Z |
| publishDate | 2006-08-01 |
| publisher | Associação Brasileira de Divulgação Científica |
| record_format | Article |
| series | Brazilian Journal of Medical and Biological Research |
| spelling | doaj.art-977fbe0d2f3644ceab4b541ac0e7dfea2022-12-21T18:26:42ZengAssociação Brasileira de Divulgação CientíficaBrazilian Journal of Medical and Biological Research0100-879X1414-431X2006-08-013981033103910.1590/S0100-879X2006000800006Proliferative diabetic retinopathy is associated with microalbuminuria in patients with type 2 diabetesM.C. BoelterJ.L. GrossL.H. CananiL.A. CostaH.R. LisboaG.S. TrêsJ. LavinskyM.J. AzevedoDiabetic retinopathy is one of the leading causes of blindness in working-age individuals. Diabetic patients with proteinuria or those on dialysis usually present severe forms of diabetic retinopathy, but the association of diabetic retinopathy with early stages of diabetic nephropathy has not been entirely established. A cross-sectional study was conducted on 1214 type 2 diabetic patients to determine whether microalbuminuria is associated with proliferative diabetic retinopathy in these patients. Patients were evaluated by direct and indirect ophthalmoscopy and grouped according to the presence or absence of proliferative diabetic retinopathy. The agreement of diabetic retinopathy classification performed by ophthalmoscopy and by stereoscopic color fundus photographs was 95.1% (kappa = 0.735; P < 0.001). Demographic information, smoking history, anthropometric and blood pressure measurements, glycemic and lipid profile, and urinary albumin were evaluated. On multiple regression analysis, diabetic nephropathy (OR = 5.18, 95% CI = 2.91-9.22, P < 0.001), insulin use (OR = 2.52, 95% CI = 1.47-4.31, P = 0.001) and diabetes duration (OR = 1.04, 95% CI = 1.01-1.07, P = 0.011) were positively associated with proliferative diabetic retinopathy, and body mass index (OR = 0.90, 95% CI = 0.86-0.96, P < 0.001) was negatively associated with it. When patients with macroalbuminuria and on dialysis were excluded, microalbuminuria (OR = 3.3, 95% CI = 1.56-6.98, P = 0.002) remained associated with proliferative diabetic retinopathy. Therefore, type 2 diabetic patients with proliferative diabetic retinopathy more often presented renal involvement, including urinary albumin excretion within the microalbuminuria range. Therefore, all patients with proliferative diabetic retinopathy should undergo an evaluation of renal function including urinary albumin measurements.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2006000800006Diabetic retinopathyDiabetic nephropathyMicroalbuminuriaType 2 diabetes mellitus |
| spellingShingle | M.C. Boelter J.L. Gross L.H. Canani L.A. Costa H.R. Lisboa G.S. Três J. Lavinsky M.J. Azevedo Proliferative diabetic retinopathy is associated with microalbuminuria in patients with type 2 diabetes Brazilian Journal of Medical and Biological Research Diabetic retinopathy Diabetic nephropathy Microalbuminuria Type 2 diabetes mellitus |
| title | Proliferative diabetic retinopathy is associated with microalbuminuria in patients with type 2 diabetes |
| title_full | Proliferative diabetic retinopathy is associated with microalbuminuria in patients with type 2 diabetes |
| title_fullStr | Proliferative diabetic retinopathy is associated with microalbuminuria in patients with type 2 diabetes |
| title_full_unstemmed | Proliferative diabetic retinopathy is associated with microalbuminuria in patients with type 2 diabetes |
| title_short | Proliferative diabetic retinopathy is associated with microalbuminuria in patients with type 2 diabetes |
| title_sort | proliferative diabetic retinopathy is associated with microalbuminuria in patients with type 2 diabetes |
| topic | Diabetic retinopathy Diabetic nephropathy Microalbuminuria Type 2 diabetes mellitus |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2006000800006 |
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