Background: Diabetic retinopathy (DR) separately has been noted as a major public health problem worldwide as well. Currently, many studies have demonstrated an association between diabetic nephropathy and DR in type 1 diabetes mellitus (T1DM) patients, but this association is less strong in T2DM. The evidence for an association between renal function and DR and visual impairment among T2DM patients is limited, particularly in the Asian population.
Aim: To assess the association between glomerular filtration rate (GFR) and DR, severe DR, and severe visual impairment among T2DM patients in Thailand.
Methods: We conducted a nationwide cross-sectional study based on the DM/HT study of the Medical Research Network of the Consortium of Thai Medical Schools. This study evaluated adult T2DM patients from 831 public hospitals in Thailand in the year 2013. GFR was categorized into ≥ 90, 60-89, 30-59 and < 30 mL/min/1.73 m2. The association between GFR and DR, severe DR, and severe visual impairment were assessed using multivariate logistic regression.
Results: A total of 13192 T2DM patients with available GFR were included in the analysis. The mean GFR was 66.9 ± 25.8 mL/min/1.73 m2. The prevalence of DR, proliferative DR, diabetic macular edema, and severe visual impairment were 12.4%, 1.8%, 0.2%, and 2.1%, respectively. Patients with GFR of 60-89, 30-59 and < 30 mL/min/1.73 m2 were significantly associated with increased DR and severe DR when compared with patients with GFR of ≥ 90 mL/min/1.73 m2. In addition, increased severe visual impairment was associated with GFR 30-59 and < 30 mL/min/1.73 m2.
Conclusion: Decreased GFR was independently associated with increased DR, severe DR, and severe visual impairment. GFR should be monitored in diabetic patients for DR awareness and prevention.
Keywords: Diabetic retinopathy; Glomerular filtration rate; Type 2 diabetes; Visual impairment.
Conflict of interest statement
Conflict-of-interest statement: The authors deny any conflict of interest.
The Association Between Renal Function and Neurological Diseases in Type 2 Diabetes: A Multicenter Nationwide Cross-Sectional StudyW Kaewput et al. Hosp Pract (1995) 47 (1), 46-52. PMID 30445880.Decreased GFR was associated with increased ischemic stroke/TIA, all cerebrovascular diseases, and peripheral neuropathy. GFR should be monitored in diabetic patients for …
Renal Function but Not Asymmetric Dimethylarginine Is Independently Associated With Retinopathy in Type 2 DiabetesK Krzyzanowska et al. Cardiol Res Pract 2011, 260191. PMID 21629851.Background. Asymmetric dimethylarginine (ADMA) is associated with macrovascular disease and possibly with microangiopathy in type 2 diabetes (T2DM). We tested the hypothe …
Diabetic Retinopathy May Predict the Renal Outcomes of Patients With Diabetic NephropathyJ Zhang et al. Ren Fail 40 (1), 243-251. PMID 29633887.These findings indicated that the severity of glomerular lesions was significantly associated with DR and DR was an independent risk factor for the renal outcomes in pati …
Common Sequence Variation in the VEGFC Gene Is Associated With Diabetic Retinopathy and Diabetic Macular EdemaG Kaidonis et al. Ophthalmology 122 (9), 1828-36. PMID 26072347.Significant associations were found between VEGFC tag SNPs (individually and within haplotypes) and the presence of any DR or DME in white participants with T1DM and T2DM …
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