Effect of urinary albumin creatinine ratio on type 2 diabetic retinopathy and is cut-off value for early diabetic retinopathy diagnosis.

ABSTRACT

OBJECTIVE: To evaluate the effect of Urinary albumin creatinine ratio (UACR) on diabetic retinopathy (DR) in People with Type 2 diabetes (T2D) and the cut-off value of UACR for predicting DR using receiver operating characteristic curve (ROC). METHODS: A prospective cohort study of 2490 people with T2D was conducted with follow-up ranging from 3 to 10 years, with a mean follow-up of 7 years. Dilated fundus examination and urine examination were performed annually. Medical history and clinical data were collected and analyzed. Linear mixed effect models with unstructured variance-covariance were carried out to longitudinally assess the influence of UACR and other factors on DR, and ROC curve was drawn to evaluate the value of UACR in early diagnosis of DR. RESULTS: Linear Mixed-effect models revealed that UACR was positively correlated with the development of DR (ß = 0.001, 95 %CI 1.023-1.241, P < 0.001). The area under the ROC curve for UACR was 0.634 (95 %CI 0.605-0.664, P < 0.001), cut-off value for early diagnosis of DR was 27.81 mg/g, the sensitivity was 0.586, and the specificity was 0.632. CONCLUSION: UACR can predict the occurrence of DR in people with T2D, so it can be considered as a preliminary indicator of DR.