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Article: Is diabetic retinopathy related to subclinical cardiovascular disease?

TitleIs diabetic retinopathy related to subclinical cardiovascular disease?
Authors
Issue Date2011
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/ophtha
Citation
Ophthalmology, 2011, v. 118 n. 5, p. 860-865 How to Cite?
AbstractObjective Persons with diabetic retinopathy (DR) have an increased risk of clinical cardiovascular events. This study aimed to determine whether DR is associated with a range of measures of subclinical cardiovascular disease (CVD) in persons without clinical CVD. Design Population-based, cross-sectional epidemiologic study. Participants Nine hundred twenty-seven persons with diabetes without clinical CVD in the Multi-Ethnic Study of Atherosclerosis. Methods Diabetic retinopathy was ascertained from retinal photographs according to modification of the Airlie House Classification system. Vision-threatening DR (VTDR) was defined as severe nonproliferative DR, proliferative DR, or clinically significant macular edema. Subclinical CVD measures were assessed and defined as follows: high coronary artery calcium (CAC) score, defined as CAC score of 400 or more; low ankle-brachial index (ABI), defined as ABI of less than 0.9; high ABI, defined as ABI of 1.4 or more; high carotid intima-media thickness (IMT), defined as highest 25% of IMT; and carotid stenosis, defined as more than 25% stenosis or presence of carotid plaque. Main Outcome Measures Associations between DR and subclinical CVD measures. Results The prevalence of DR and VTDR in this sample was 30.0% and 7.2%, respectively, and VTDR was associated with a high CAC score (odds ratio [OR], 2.33; 95% confidence interval [CI], 1.154.73), low ABI (OR, 2.54; 95% CI, 1.085.99), and high ABI (OR, 12.6; 95% CI, 1.14140.6) after adjusting for risk factors including hemoglobin A1c level and duration of diabetes. The association between VTDR and high CAC score remained significant after further adjustment for hypoglycemic, antihypertensive, and cholesterol-lowering medications. Diabetic retinopathy was not significantly associated with measures of carotid artery disease. Conclusions In persons with diabetes without a history of clinical CVD, the presence of advanced-stage DR is associated with subclinical coronary artery disease. These findings emphasize the need to be careful about the use of antivascular endothelial growth factor for the treatment of DR. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article. © 2011 American Academy of Ophthalmology.
Persistent Identifierhttp://hdl.handle.net/10722/183607
ISSN
2015 Impact Factor: 6.75
2015 SCImago Journal Rankings: 4.745
PubMed Central ID
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorKawasaki, Ren_US
dc.contributor.authorCheung, Nen_US
dc.contributor.authorIslam, FMAen_US
dc.contributor.authorKlein, Ren_US
dc.contributor.authorKlein, BEKen_US
dc.contributor.authorCotch, MFen_US
dc.contributor.authorSharrett, ARen_US
dc.contributor.authorO'leary, Den_US
dc.contributor.authorWong, TYen_US
dc.date.accessioned2013-05-28T06:15:19Z-
dc.date.available2013-05-28T06:15:19Z-
dc.date.issued2011en_US
dc.identifier.citationOphthalmology, 2011, v. 118 n. 5, p. 860-865en_US
dc.identifier.issn0161-6420en_US
dc.identifier.urihttp://hdl.handle.net/10722/183607-
dc.description.abstractObjective Persons with diabetic retinopathy (DR) have an increased risk of clinical cardiovascular events. This study aimed to determine whether DR is associated with a range of measures of subclinical cardiovascular disease (CVD) in persons without clinical CVD. Design Population-based, cross-sectional epidemiologic study. Participants Nine hundred twenty-seven persons with diabetes without clinical CVD in the Multi-Ethnic Study of Atherosclerosis. Methods Diabetic retinopathy was ascertained from retinal photographs according to modification of the Airlie House Classification system. Vision-threatening DR (VTDR) was defined as severe nonproliferative DR, proliferative DR, or clinically significant macular edema. Subclinical CVD measures were assessed and defined as follows: high coronary artery calcium (CAC) score, defined as CAC score of 400 or more; low ankle-brachial index (ABI), defined as ABI of less than 0.9; high ABI, defined as ABI of 1.4 or more; high carotid intima-media thickness (IMT), defined as highest 25% of IMT; and carotid stenosis, defined as more than 25% stenosis or presence of carotid plaque. Main Outcome Measures Associations between DR and subclinical CVD measures. Results The prevalence of DR and VTDR in this sample was 30.0% and 7.2%, respectively, and VTDR was associated with a high CAC score (odds ratio [OR], 2.33; 95% confidence interval [CI], 1.154.73), low ABI (OR, 2.54; 95% CI, 1.085.99), and high ABI (OR, 12.6; 95% CI, 1.14140.6) after adjusting for risk factors including hemoglobin A1c level and duration of diabetes. The association between VTDR and high CAC score remained significant after further adjustment for hypoglycemic, antihypertensive, and cholesterol-lowering medications. Diabetic retinopathy was not significantly associated with measures of carotid artery disease. Conclusions In persons with diabetes without a history of clinical CVD, the presence of advanced-stage DR is associated with subclinical coronary artery disease. These findings emphasize the need to be careful about the use of antivascular endothelial growth factor for the treatment of DR. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article. © 2011 American Academy of Ophthalmology.en_US
dc.languageengen_US
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/ophthaen_US
dc.relation.ispartofOphthalmologyen_US
dc.subject.meshAgeden_US
dc.subject.meshAged, 80 And Overen_US
dc.subject.meshCardiovascular Diseases - Diagnosis - Epidemiology - Etiologyen_US
dc.subject.meshCohort Studiesen_US
dc.subject.meshCoronary Angiographyen_US
dc.subject.meshCross-Sectional Studiesen_US
dc.subject.meshDiabetic Retinopathy - Complications - Diagnosis - Epidemiologyen_US
dc.subject.meshElectrocardiographyen_US
dc.subject.meshEpidemiologic Studiesen_US
dc.subject.meshEthnic Groupsen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshMacular Edema - Complications - Diagnosis - Epidemiologyen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPrevalenceen_US
dc.subject.meshRetinal Neovascularization - Complications - Diagnosis - Epidemiologyen_US
dc.subject.meshRisk Factorsen_US
dc.subject.meshTomography, X-Ray Computeden_US
dc.subject.meshUnited States - Epidemiologyen_US
dc.titleIs diabetic retinopathy related to subclinical cardiovascular disease?en_US
dc.typeArticleen_US
dc.identifier.emailCheung, N: dannycheung@hotmail.comen_US
dc.identifier.authorityCheung, N=rp01752en_US
dc.description.naturelink_to_OA_fulltexten_US
dc.identifier.doi10.1016/j.ophtha.2010.08.040en_US
dc.identifier.pmid21168222-
dc.identifier.pmcidPMC3087839-
dc.identifier.scopuseid_2-s2.0-79955583894en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-79955583894&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume118en_US
dc.identifier.issue5en_US
dc.identifier.spage860en_US
dc.identifier.epage865en_US
dc.identifier.isiWOS:000290090300011-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridKawasaki, R=35229910100en_US
dc.identifier.scopusauthoridCheung, N=8054683900en_US
dc.identifier.scopusauthoridIslam, FMA=35446440500en_US
dc.identifier.scopusauthoridKlein, R=35232138400en_US
dc.identifier.scopusauthoridKlein, BEK=35433541400en_US
dc.identifier.scopusauthoridCotch, MF=6603036992en_US
dc.identifier.scopusauthoridSharrett, AR=7006662570en_US
dc.identifier.scopusauthoridO'Leary, D=7201977778en_US
dc.identifier.scopusauthoridWong, TY=7403531208en_US

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