TD2 patients with diabetic nephropathy have high risk of retinopathy

A new study published in BMC Endocrine Disorders suggests that people with type 2 diabetes mellitus (DM) and diabetic nephropathy (DN) have a relatively high prevalence of diabetic retinopathy (DR).

Diabetic retinopathy (DR) is one of the most common microvascular complications of DM and the leading cause of preventable blindness in working-age people. Several studies have shown an association between DR and diabetic nephropathy in DM patients, as all belong to the microvascular complications of DM. Therefore, this study was conducted by Yujie Yan and his team to investigate the characteristics of retinal microvascular changes and their risk factors in patients with diabetic nephropathy (DN).

A retrospective observational study was conducted. 145 patients with type 2 diabetes and DN participated in the study. Demographic and clinical parameters were determined from medical records. The presence of diabetic retinopathy, hard exudate (HE), and diabetic macular edema (DME) was assessed using color fundus imaging, optical coherence tomography (OCT), and fluorescence angiography (FFA) .

The main results of this study are:

1. Among type 2 DM patients with DN, DR accounted for 61.4%, of which 23.6% had proliferative diabetic retinopathy (PDR) and 35.7% had sight-threatening DR.

2. The DR group had significantly higher scores for low-density lipoprotein cholesterol (LDL-C) (p =0.004), HbA1c (P =0.037), urinary albumin creatine ratio (ACR) (p <0.001), estimated thread Low degree of spherical filtration rate (eGFR) (P=0.013).

3. Logistic regression analysis showed that DR was significantly associated with ACR stage (p = 0.011).

4. ACR stage 3 subjects experienced DR more frequently than ACR stage 1 subjects.

5. HE and DME in 138 eyes of 138 patients were analyzed, of which 23.2% had posterior pole HE and 9.4% had DME.

6. Visual acuity in the HE group was worse than in the non-HE group.

7. There were significant differences in LDL-C cholesterol, total cholesterol (CHOL), and ACR between HE and non-HE groups.

In summary, patients with DN require more timely and frequent ophthalmologic examinations.

Reference:

Yan, Y., Yu, L., Sun, C., Zhao, H., Zhang, H., & Wang, Z. (2023). Retinal microvascular changes in diabetic patients with diabetic nephropathy. In BMC Endocrine Disorders (Vol. 23, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1186/s12902-022-01250-w