Association of Diabetic Retinopathy and Maculopathy with Elevated HbA1c, Blood Pressure, Serum Creatinine, Microalbuminuria, Spot Urine Protein, Nephropathy and Diabetic Kidney Disease. An Experience from Data Analysis of 10,580 Diabetic Patients
Journal Title: Journal of Endocrinology and Diabetes - Year 2018, Vol 5, Issue 1
Abstract
Background: Diabetic kidney disease and retinopathy are the most important complications which usually co-exist together with high economic cost, morbidity, and mortality. Current research was designed to study these two complications and their associations with impaired glycemic control, elevated blood pressure, serum creatinine and proteinuria. Methods: 10, 580 patients were selected for this study. Retinopathy was graded as: within normal limits (WNL), non-proliferative diabetic retinopathy (npdr mild, moderate or severe), or proliferative diabetic retinopathy (PDR) . For detection of diabetic kidney disease (DKD), patients were screened for elevated serum creatinine, microalbuminuria, and spot urine protein. Serum creatinine ≥ 1.5 mg/dl was labeled as “DKD”. Results: Severity (grading) of retinopathy increases with the advancement of duration of diabetes, HbA1c , serum creatinine, microalbuminuria, spot urine protein, and blood pressure (systolic and diastolic). ANOVA model P-values were significant for all tested variables (p < 0.0001 for all). Group of patients with maculopathy have higher levels of HbA1c, duration of diabetes, serum creatinine, microalbuminuria, spot urine protein and creatinine and their ratio (PCR), systolic and diastolic blood pressure with significant p-values. Significant , χ2 associations were observed for retinopathy with hypertension, and nephropathy with DKD (odds ratio 2.29 and 2.1, respectively; p < 0.0001 for all). For the development of retinopathy, ROC curve demonstrated cutoff point of 8.9 % (g/dl) for HbA1c, with 67% sensitivity and 50% specificity; 129 mmhg for systolic BP with 70% sensitivity and 55% specificity; and 79 mmhg for diastolic BP with 63% sensitivity and 51% specificity. Conclusion: We concluded that all diabetic patients should be screened early for the detection of retinopathy, nephropathy, elevated serum creatinine, HbA1c and hypertension to prevent further diabetes complications.
Authors and Affiliations
Kamran Mahmood Ahmed Aziz
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- EP ID EP334050
- DOI 10.15226/2374-6890/5/1/00195
- Views 86
- Downloads 0
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