Retinopathy predicts coronary heart disease events in NIDDM patients
Retinopathy predicts coronary heart disease events in NIDDM patients
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DOI：
10.2337/diacare.19.12.1445
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发表时间：
1996-12-01
期刊：
影响因子：
16.2
通讯作者：
Laakso, M
中科院分区：
文献类型：
--
作者：
Miettinen, H;Haffner, SM;Laakso, M
目的：增殖性视网膜病变已被证明与糖尿病患者全因死亡率的增加有关。在一项对NIDDM患者的前瞻性人群研究中，我们评估了基线时视网膜病变的不同程度与严重冠心病(CHD)事件(CHD死亡或非致命性心肌梗死)之间的关系。研究设计和方法--我们的研究基于芬兰东部和西部1059名NIDDM患者的7年随访队列。视网膜病变的分类以眼底的临床检查为基础，根据不良眼的状态将其分为三类：无视网膜病变、背景视网膜病变和增殖性视网膜病变。结果：在7年的随访中，255例(24%)患者发生了严重的CHD事件。在基线水平的增殖性视网膜病变患者中，随访期间发生冠心病事件的风险显著高于无视网膜病变的患者(优势比[OR]2.31，95%可信区间1.21-4.40)。在控制其他心血管危险因素后，增殖性视网膜病变与CHD事件之间的相关性仍然显著。结论NIDDM患者的增殖性视网膜病变与CHD事件相关。我们的发现提示视网膜病变和CHD可能有相似的病理生理背景。
OBJECTIVE - Proliferative retinopathy has been shown to be associated with increased all-cause mortality in diabetic patients. We assessed the relationship between the different degrees of retinopathic changes at baseline and serious coronary heart disease (CHD) events (CHD death or nonfatal myocardial infarction) in a prospective population-based study of NIDDM patients.RESEARCH DESIGN AND METHODS - Our study is based on the 7-year follow-up cohort of 1,059 NIDDM patients in east and west Finland. Classification of retinopathic changes was based on clinical examination of fundi, and the findings were classified to three categories according to the status of the worse eye: no retinopathic changes, background retinopathy, and proliferative retinopathy.RESULTS - During the 7-year follow-up, 255 (24%) patients developed serious CHD event. In patients with proliferative retinopathy at baseline, the risk of CHD events during the follow-up was statistically significantly higher compared with patients without retinopathic changes (odds ratio [OR] 2.31, 95% CI 1.21-4.40). The association between proliferative retinopathy and CHD events remained significant when other cardiovascular risk factors were controlled for.CONCLUSIONS - Proliferative retinopathy in NIDDM patients was associated with CHD events. Our findings suggest that retinopathy and CHD may have similar pathophysiological backgrounds.