ABSTRACT
Objective To analyze risk factors for diabetic retinopathy without proteinuria in type 2 diabetic patients． Methods The clinical data of type 2 diabetic patients were retrospectively analyzed. These patients were divided into two groups based on the results of fundus examination. Basic clinical data were compared in simple diabetic retinopathy (DR, without albuminuria and DPN) group including 169 cases and non-diabetic retinopathy (NO-DR, without microvascular complications) group including 208 cases. Logistic regression analysis was used to analyze the risk factors of DR. Among DR, 60 patients were mild non-proliferation DR (NPDR), 82 patients were moderate NPDR, 20 patients were severe NPDR and 7 patients were proliferation DR (PDR). Severe NPDR and PDR were combined into severe DR group. The correlation between risk factors and DR staging were analyzed by Pearson correlation analysis. Results The results showed that duration of diabetes, HbA1c, systolic blood pressure, diastolic blood pressure, postprandial blood glucose, triglyceride, serum creatinine, cystatin C and ratio of statin were higher in DR group, but age at onset of diabetes, CKD-EPI formula estimated GFR, fasting c-peptide and postprandial c-peptide were lower in DR group than that in NDR group (P<0.05). Logistic regression analysis showed that young age at onset of diabetes (OR:0.914, P≤0.001), hypertriglyceridemia (OR:1.369, P<0.05), high systolic pressure (OR:1.041, P<0.01) and reduced GFR (OR:0.912, P≤0.001) were the risk factors of DR. Pearson correlation analysis demonstrated that GFR was negatively correlated to DR staging (r=-0.513, P<0.001), TG (r=0.110，P<0.033) and SBP (r=0.231, P<0.001） were positive correlated to DR staging. Conclusion In addition to the traditional factors, simple diabetic retinopathy in type 2 diabetic patients was related to young age at onset of diabetes, high systolic pressure, hypertriglyceridemia and reduced eGFR. eGFR decline occurred before the proteinuria and associated with the development of DR was a predicted factor of DR.
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the relationship between 25-hydroxy vitamin D [25(OH)D] and carotid artery intimal medial thickness (IMT) in type 2 diabetic (T2DM) patients.</p><p><b>METHODS</b>Serum 25(OH)D and carotid IMT were measured in 300 T2DM patients. Patients were divided into four quartile groups according to the serum 25(OH)D levels (Q1: < 26.17 nmol/L, 74 cases; Q2: 26.17 - 32.75 nmol/L, 76 cases; Q3: 32.75 - 42.93 nmol/L, 78 cases; Q4 > 42.93 nmol/L, 72 cases).</p><p><b>RESULTS</b>Carotid IMT, carotid artery plaque prevalence, duration of diabetes, HbA1c, CRP and PTH were significantly higher in subjects with low 25(OH)D compared subjects with high 25(OH)D (P < 0.05). Carotid artery IMT in Q1 and Q2 groups were significantly higher than that in Q4 group (1.03 ± 0.21 vs. 0.90 ± 0.20, 1.01 ± 0.26 vs. 0.90 ± 0.20, P < 0.05), was similar among Q1 and Q2 and Q3 groups. Prevalence of carotid atherosclerotic plaque in Q1 group (50.0%) was also significantly higher than in Q3 (29.5%, P < 0.05) and Q4 (16.7%, P < 0.05). Similarly, 25(OH)D concentration was significantly lower in patients with carotid plaque compared patients without carotid plaque [(28.31 ± 4.91) nmol/L vs. (36.31 ± 4.31) nmol/L, P < 0.01]. Pearson correlation analysis showed that carotid IMT was positively correlated with age, smoking, BMI, HbA1c, CRP, LDL-C, PTH/25(OH)D ratio (P < 0.05), and was negatively correlated with 25 (OH) D (r = -0.51, P < 0.01). Multivariate regression analysis showed that 25(OH)D concentration was an independent predictor of carotid IMT in this cohort (β = -0.39, P < 0.01).</p><p><b>CONCLUSION</b>Serum 25(OH)D concentration is negatively correlated with carotid IMT and low 25 (OH) D level is a risk factor for preclinical atherosclerosis in T2DM patients.</p>