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Stroke incidence increases with diabetic retinopathy severity and macular edema in type 1 diabetes.
Eriksson, Marika I; Hietala, Kustaa; Summanen, Paula; Harjutsalo, Valma; Putaala, Jukka; Ylinen, Anni; Hägg-Holmberg, Stefanie; Groop, Per-Henrik; Thorn, Lena M.
Afiliación
  • Eriksson MI; Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.
  • Hietala K; Department of Nephrology, University of Helsinki and Helsinki University Hospital, Biomedicum Helsinki Haartmaninkatu 8, Helsinki, FIN-00290, Finland.
  • Summanen P; Research Program in Clinical and Molecular Metabolism, University of Helsinki, Helsinki, Finland.
  • Harjutsalo V; Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.
  • Putaala J; Hospital Nova of Central Finland, Jyväskylä, Finland.
  • Ylinen A; Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.
  • Hägg-Holmberg S; Research Program in Clinical and Molecular Metabolism, University of Helsinki, Helsinki, Finland.
  • Groop PH; Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
  • Thorn LM; Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.
Cardiovasc Diabetol ; 23(1): 136, 2024 Apr 25.
Article en En | MEDLINE | ID: mdl-38664827
ABSTRACT

BACKGROUND:

As the retina is suggested to mirror the brain, we hypothesized that diabetic retinopathy and macular edema are indicative of stroke risk in type 1 diabetes and sought to assess this association in individuals with type 1 diabetes.

METHODS:

We included 1,268 adult FinnDiane Study participants with type 1 diabetes (age 38.7 ± 11.8 years, 51.7% men vs. 48.3% women, and 31.5% had diabetic kidney disease), data on baseline diabetic retinopathy severity, and first stroke during our observational follow-up. Retinopathy was graded by the Early Treatment Diabetic Retinopathy Study (ETDRS) scale, and macular edema as clinically significant (CSME) or not. Strokes identified from registries were confirmed from medical files. Adjusted hazard ratios (HR) for stroke by retinopathy severity and CSME were calculated by Cox models adjusted for clinical confounders, including diabetic kidney disease.

RESULTS:

During median 18.0 (14.1-19.3) follow-up years, 130 strokes (96 ischemic, 34 hemorrhagic) occurred. With no-very mild (ETDRS 10-20) retinopathy as reference, the adjusted HR for stroke was 1.79 (95%CI 1.02-3.15) in non-proliferative (ETDRS 35-53), and 1.69 (1.02-2.82) in proliferative (ETDRS 61-85) retinopathy. Corresponding adjusted HR for ischemic stroke was 1.68 (0.91-3.10) in non-proliferative and 1.35 (0.77-2.36) in proliferative retinopathy. The adjusted HR for hemorrhagic stroke was 2.84 (0.66-12.28) in non-proliferative and 4.31 (1.16-16.10) in proliferative retinopathy. CSME did not increase HR for any stroke type after adjustment for clinical confounders (data not shown).

CONCLUSIONS:

Stroke incidence increases with the severity of diabetic retinopathy independently of comorbid conditions, including diabetic kidney disease.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Índice de Severidad de la Enfermedad / Edema Macular / Diabetes Mellitus Tipo 1 / Retinopatía Diabética Límite: Adult / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Cardiovasc Diabetol Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA / ENDOCRINOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Finlandia

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Índice de Severidad de la Enfermedad / Edema Macular / Diabetes Mellitus Tipo 1 / Retinopatía Diabética Límite: Adult / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Cardiovasc Diabetol Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA / ENDOCRINOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Finlandia