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https://doi.org/10.1007/s00125-017-4538-2
Title: | The Adolescent Cardio-Renal Intervention Trial (AdDIT): retinal vascular geometry and renal function in adolescents with type 1 diabetes | Authors: | Benitez-Aguirre, P.Z Wong, T.Y Craig, M.E |
Keywords: | albumin creatinine dipeptidyl carboxypeptidase inhibitor glucose hydroxymethylglutaryl coenzyme A reductase inhibitor albuminoid adolescent albuminuria algorithm Article blood glucose monitoring blood pressure body mass calibration cohort analysis controlled study cross-sectional study diabetic nephropathy diabetic patient disease duration female geometry high risk population human hypertension insulin dependent diabetes mellitus kidney function low risk population major clinical study male microalbuminuria multicenter study peripheral retina priority journal randomized controlled trial retina blood vessel retinal arteriole retinal vascular geometry screening test software venule arteriole complication diabetic retinopathy insulin dependent diabetes mellitus kidney pathology pathophysiology phenotype prospective study regression analysis retina retina blood vessel risk factor Adolescent Albumins Albuminuria Arterioles Blood Pressure Body Mass Index Cross-Sectional Studies Diabetes Mellitus, Type 1 Diabetic Retinopathy Female Humans Kidney Male Phenotype Prospective Studies Regression Analysis Retina Retinal Vessels Risk Factors |
Issue Date: | 2018 | Publisher: | Springer Verlag | Citation: | Benitez-Aguirre, P.Z, Wong, T.Y, Craig, M.E (2018). The Adolescent Cardio-Renal Intervention Trial (AdDIT): retinal vascular geometry and renal function in adolescents with type 1 diabetes. Diabetologia 61 (4) : 968-976. ScholarBank@NUS Repository. https://doi.org/10.1007/s00125-017-4538-2 | Rights: | Attribution 4.0 International | Abstract: | Aims/hypothesis: We examined the hypothesis that elevation in urinary albumin creatinine ratio (ACR) in adolescents with type 1 diabetes is associated with abnormal retinal vascular geometry (RVG) phenotypes. Methods: A cross-sectional study at baseline of the relationship between ACR within the normoalbuminuric range and RVG in 963 adolescents aged 14.4 ± 1.6 years with type 1 diabetes (median duration 6.5 years) screened for participation in AdDIT. A validated algorithm was used to categorise log10 ACR into tertiles: upper tertile ACR was defined as ‘high-risk’ for future albuminuria and the lower two tertiles were deemed ‘low-risk’. RVG analysis, using a semi-automated computer program, determined retinal vascular calibres (standard and extended zones) and tortuosity. RVG measures were analysed continuously and categorically (in quintiles: Q1–Q5) for associations with log10 ACR and ACR risk groups. Results: Greater log10 ACR was associated with narrower vessel calibres and greater tortuosity. The high-risk group was more likely to have extended zone vessel calibres in the lowest quintile (arteriolar Q1 vs Q2–Q5: OR 1.67 [95% CI 1.17, 2.38] and venular OR 1.39 [0.98, 1.99]) and tortuosity in the highest quintile (Q5 vs Q1–Q4: arteriolar OR 2.05 [1.44, 2.92] and venular OR 2.38 [1.67, 3.40]). The effects of retinal vascular calibres and tortuosity were additive such that the participants with the narrowest and most tortuous vessels were more likely to be in the high-risk group (OR 3.32 [1.84, 5.96]). These effects were independent of duration, blood pressure, BMI and blood glucose control. Conclusions/interpretation: Higher ACR in adolescents is associated with narrower and more tortuous retinal vessels. Therefore, RVG phenotypes may serve to identify populations at high risk of diabetes complications during adolescence and well before onset of clinical diabetes complications. © 2018, The Author(s). | Source Title: | Diabetologia | URI: | https://scholarbank.nus.edu.sg/handle/10635/179046 | ISSN: | 0012186X | DOI: | 10.1007/s00125-017-4538-2 | Rights: | Attribution 4.0 International |
Appears in Collections: | Elements Staff Publications |
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