Epidemiology of Retinopathy and other Complications in Long Term Type 1 Diabetes

长期 1 型糖尿病视网膜病变和其他并发症的流行病学

• 批准号: 8461555
• 负责人: BARBARA EDEN KLEIN
• 金额: $ 134.99万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-01 至 2017-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8461555
• 关键词: Address; Advanced Glycosylation End Products; Age-Years; Amputation; Antioxidants; Area; Atherosclerosis; Blood Pressure; Caliber; Candidate Disease Gene; Cardiovascular Diseases; Caring; Carotid Arteries; Characteristics; Charge; Cognition; Cohort Studies; Complications of Diabetes Mellitus; County; Creatinine; Data; Diabetes Mellitus; Diabetic Nephropathy; Diabetic Neuropathies; Diabetic Retinopathy; Diagnosis; Early Diagnosis; Early Intervention; Electrocardiogram; Epidemiologic Studies; Epidemiology; Etiology; Fluorescence; Freezing; Frequencies; Funding; Fundus photography; Goals; Grant; Impaired cognition; Insulin; Insulin-Dependent Diabetes Mellitus; Intervention; Kidney Diseases; LDL Cholesterol Lipoproteins; Lead; Life; Lipids; Lower Extremity; Lysine; Measurement; Measures; Medial; Medical; Morbidity - disease rate; Myocardial Infarction; Neuropathy; Outcome; Oxidative Stress; Pathway interactions; Patients; Persons; Physicians; Preventive; Protocols documentation; Public Health; Retinal; Retinal Diseases; Risk; Risk Factors; Serum; Severities; Skin; Stress; Stroke; Testing; Therapeutic; Thick; Time; Ultrasonography; Vision; Visual Acuity; Wisconsin; abstracting; blood pressure regulation; cohort; experience; follow-up; glycemic control; high risk; improved; macular edema; modifiable risk; mortality; non-diabetic; oxidized low density lipoprotein; pentosidine; prevent; proliferative diabetic retinopathy; receptor for advanced glycation endproducts; retina blood vessel structure; stereoscopic

Epidemiology of Retinopathy and Other Complications in Long Term Type 1 Diabetes Project Summary / Abstract Persons with long term type 1 diabetes mellitus (T1DM) are at high risk of developing severe complications, presenting a pressing need to prevent these outcomes. It is, therefore, the goal of this epidemiological study to determine the relationship of specific underexamined risk factors for these complications that hold promise of diminishing these risks beyond the improvements achieved with current strategies. This study aims to measure advanced glycation endproducts (AGEs), receptors for AGEs (RAGE), carotid intimal-medial thickness, markers of antioxidant stress, and related candidate genes and their relationships to diabetic retinopathy, diabetic nephropathy, diabetic neuropathy, myocardial infarction, stroke, and cognitive dysfunction outcomes. In addition, the study will determine the relationship of retinal vessel diameters and severity of diabetic retinopathy to diabetic nephropathy, diabetic neuropathy, MI, stroke, and cognitive dysfunction. This proposal builds on a longitudinal representative cohort study of persons with long duration of T1DM participating in the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR, funded by NEI grants R01 EY03083 and R01 EY016379). The study included all insulin-taking persons with type 1 diabetes who were receiving primary medical care in an 11-county area of southwestern Wisconsin in 1979- 1980. They were examined in 1980-1982 and approximately every 5 years thereafter. Objective recording of retinopathy from stereoscopic fundus photography combined with a standardized grading, refraction and visual acuity, carotid artery ultrasound, electrocardiogram, measurement of skin intrinsic fluorescence, tests of cognition, and measurement of serum (e.g., AGEs [carboxymethyl lysine, pentosidine], soluble RAGE, oxidized low density lipoprotein cholesterol, creatinine) according to standardized protocols will be obtained in the proposed examination. In addition, we will measure AGEs, RAGE and oxidized low density lipoprotein cholesterol from frozen serum from previous exams to determine longitudinal associations with PDR and other complications. The new data from this study will provide a unique opportunity to determine why, independent of glycemic and blood pressure control, and despite long duration of T1DM, some persons have minimal to mild diabetic retinopathy, diabetic nephropathy, diabetic neuropathy, cognitive dysfunction, and less severe cardiovascular disease, while others have more severe complications. These data will be important to patients and their physicians in developing new interventions for managing type 1 diabetes and to public health practitioners charged with delivering preventive care.

长期1型糖尿病视网膜病变及其他并发症的流行病学研究 项目总结/摘要 长期1型糖尿病（T1 DM）患者发生严重 并发症，迫切需要防止这些结果。因此， 流行病学研究，以确定特定的未充分检查的风险因素之间的关系， 这些并发症有希望减少这些风险，超越目前的改进 战略布局本研究旨在测量晚期糖基化终产物（AGEs），AGEs受体（AGEs）， 颈动脉内膜-中层厚度、抗氧化应激标志物和相关候选基因及其 与糖尿病视网膜病变、糖尿病肾病、糖尿病神经病变、心肌梗死、中风 和认知功能障碍的结果。此外，该研究还将确定视网膜血管的关系 糖尿病视网膜病变的直径和严重程度与糖尿病肾病、糖尿病神经病变、MI、卒中和 认知功能障碍这项建议是建立在对长期吸烟者的纵向代表性队列研究的基础上的。 参与威斯康星州糖尿病视网膜病变流行病学研究（WESDR，资助 由NEI赠款R 01 EY 03083和R 01 EY 016379）。这项研究包括所有服用胰岛素的1型糖尿病患者， 1979年，在威斯康星州西南部的一个11县地区， 1980.他们在1980-1982年进行了检查，此后大约每5年进行一次检查。客观记录 视网膜病变的立体眼底照相结合标准化分级，屈光和视力 敏锐度，颈动脉超声，心电图，皮肤固有荧光测量， 认知和血清的测量（例如，AGEs [羧甲基赖氨酸，戊糖苷]，可溶性，氧化 低密度脂蛋白胆固醇、肌酸酐）的水平。 建议考试。此外，我们还将检测AGEs、CRP和氧化低密度脂蛋白 从先前检查的冷冻血清中提取胆固醇，以确定与PDR和其他 并发症这项研究的新数据将提供一个独特的机会，以确定为什么，独立 血糖和血压控制，尽管T1 DM持续时间长，但有些人的血糖和血压控制很少， 轻度糖尿病视网膜病变、糖尿病肾病、糖尿病神经病变、认知功能障碍， 心血管疾病，而其他人有更严重的并发症。这些数据将对患者很重要 和他们的医生开发新的干预措施来管理1型糖尿病和公共卫生 负责提供预防保健的从业人员。