Early changes in glomerular size selectivity in young adults with type 1 diabetes and retinopathy. Results from the Diabetes Incidence Study in Sweden

Torffvit, Ole; Eriksson, Jan W.; Henricsson, Marianne; Sundkvist, Göran; Arnqvist, Hans J.; Blohmé, G; Bolinder, Jan; Nyström, Lennarth; Östman, Jan; Svensson, Maria

doi:10.1016/j.jdiacomp.2006.01.002

Cited by 11 publications

(8 citation statements)

References 44 publications

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“…The prevalence of NPR at the beginning of the study in our patients was 30%, which is much lower to the prevalence of retinopathy reported in previous studies including normoalbuminuric patients with type 1 diabetes [5,6,21]. After 48 months of following, UAE, systolic blood pressure and resting heart rate were risk factors for development or progression of NPR in our normoalbuminuric patients with type 1 diabetes.…”

Section: Discussioncontrasting

confidence: 79%

“…It has been documented that some patients with advanced retinopathy have normal UAE and glomerular morphology determined with renal biopsy [15]. However, in most subjects a normal UAE does not imply normal renal function and does not exclude glomerular barrier damage because normoalbuminuric patients with type 1 diabetes and retinopathy have preclinical renal morphologic changes, higher urinary IgG2, IgG4 excretion and higher IgG2/creatinine and IgG2/IgG4 ratios compared to the patients without retinopathy [6,21,30]. Moreover, the cutt-off point for microalbuminuria is based on findings from studies in the 1980s in which the progression rate to nephropathy was very high in patients with values of UAE of 30 mg/24h [31].…”

Section: Discussionmentioning

confidence: 99%

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Risk factors for development and progression of nonproliferative retinopathy in normoalbuminuric patients with type 1 diabetes

Bulum

Blaslov

Duvnjak

2014

Diabetes Research and Clinical Practice

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Section: Discussioncontrasting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Risk factors for development and progression of nonproliferative retinopathy in normoalbuminuric patients with type 1 diabetes

Bulum

Blaslov

Duvnjak

2014

Diabetes Research and Clinical Practice

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“…The present study demonstrates that a higher resting HR is associated with a higher risk of nonproliferative retinopathy in patients with type 1 diabetes. The prevalence of nonproliferative retinopathy in our patients was 36%, which is much lower than the prevalence of retinopathy reported in previous studies, including normoalbuminuric patients with type 1 diabetes . Patients with nonproliferative retinopathy had significantly higher metabolic risk factors including age, duration of diabetes, HbA 1c , and resting HR.…”

Section: Discussioncontrasting

confidence: 81%

“…The prevalence of nonproliferative retinopathy in our patients was 36%, which is much lower than the prevalence of retinopathy reported in previous studies, including normoalbuminuric patients with type 1 diabetes. 5,17 Patients with nonproliferative retinopathy had significantly higher metabolic risk factors including age, duration of diabetes, HbA 1c , and resting HR. However, in multiple logistic regression analysis, only resting HR was independently related to nonproliferative retinopathy, even after adjusting for glycemic control and other risk factors.…”

Section: Discussionmentioning

confidence: 99%

Resting Heart Rate Is Associated With Nonproliferative Retinopathy in Normoalbuminuric Type 1 Diabetic Patients

Bulum

Blaslov

Duvnjak

2013

J of Clinical Hypertension

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Previous studies have reported that retinopathy might be already present in the normoalbuminuric state in type 1 diabetic patients. The aim of this study was to evaluate the prevalence and predictors of nonproliferative retinopathy in normoalbuminuric type 1 diabetic patients. The study included 312 normoalbuminuric type 1 diabetic patients with normal renal function before any interventions with statins, angiotensin-converting enzyme inhibitors, or angiotensin II receptor blockers. Diagnosis of nonproliferative retinopathy was made by fundoscopy after pupillary dilatation. Urinary albumin excretion (UAE) rate was measured from at least two 24-hour urine samples. Nonproliferative retinopathy was present in 36% of normoalbuminuric patients. Patients with nonproliferative retinopathy were older and had longer duration of diabetes, higher hemoglobin A1c , daily insulin dose, and higher resting heart rate (RHR) (P≤.01 for all). Patients in the 4th quartile of RHR were older and had longer duration of diabetes, higher hemoglobin A1c , daily insulin dose, serum creatinine, UAE, and a significantly higher prevalence of nonproliferative retinopathy compared with subjects in the 2nd, 3rd, and 4th quartiles (P<.05). In logistic regression analysis, after adjustment for risk factors, higher RHR was significantly associated with risk of nonproliferative retinopathy in patients (P<.001), with odds ratios of 1.02 to 1.08. These data suggest that RHR is independently associated with nonproliferative retinopathy in normoalbuminuric type 1 diabetic patients.

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“…It is known that, on the one hand, HT accelerates and reinforces micro- and macrovascular complications in diabetes; on the other hand, in patients with type I diabetes who suffer from diabetic nephropathy, arterial HT is considered to be the secondary result of kidney lesion. 34, 35 In recent years, the necessity for the 24-h measurement of blood pressure in patients with T1DM has been raised to monitor and discover early changes in the blood pressure profile, manifested by the drop of blood pressure during the night, which may be the first symptom of microangiopathy. 34, 36, 37 …”

Section: Discussionmentioning

confidence: 99%

Association between vascular endothelial growth factor and hypertension in children and adolescents type I diabetes mellitus

et al. 2010

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The aim of the study was to analyse the relationship between the serum level of vascular endothelial growth factor (VEGF) and the incidence of hypertension (HT) in children and adolescents with type I diabetes mellitus (T1DM). One hundred and five patients with T1DM were enrolled in the study. The control group consisted of 30 healthy controls. All the T1DM patients were subjected to biochemical analyses, ophthalmologic examination and 24-h blood pressure monitoring. Besides, all the patients and healthy controls had serum VEGF levels measured with the use of the ELISA methodology. The essence of our research is that patients with T1DM and HT and with microalbuminuria (MA) and diabetic retinopathy (DR) (MA/DR) are characterized by a significantly higher level of VEGF (340.23±93.22 pg ml–1) in blood serum in comparison with the group of T1DM patients without HT and MA/DR (183.6±96.6 pg ml–1) and with healthy controls (145.32±75.58 pg ml–1). In addition, the VEGF level was significantly higher in T1DM patients, who presented all three complications, that is HT, retinopathy and MA in comparison with T1DM patients without HT, but with MA/DR (P=0.036). On the other hand, no statistically significant differences (P=0.19) were noted in the level of VEGF in serum between T1DM patients without HT and MA/DR and the healthy control group. At a further stage of analysis, using the method of multiple regression, it was shown that systolic pressure, HbA1c and duration of disease are independent factors influencing the concentration of VEGF. Summarizing, the measurement of VEGF serum levels allows for the identification of groups of patients who have the highest risk of HT and, subsequently, progression of vascular complications.

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Early changes in glomerular size selectivity in young adults with type 1 diabetes and retinopathy. Results from the Diabetes Incidence Study in Sweden

Cited by 11 publications

References 44 publications

Risk factors for development and progression of nonproliferative retinopathy in normoalbuminuric patients with type 1 diabetes

Risk factors for development and progression of nonproliferative retinopathy in normoalbuminuric patients with type 1 diabetes

Resting Heart Rate Is Associated With Nonproliferative Retinopathy in Normoalbuminuric Type 1 Diabetic Patients

Association between vascular endothelial growth factor and hypertension in children and adolescents type I diabetes mellitus

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