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: 8294242
• 负责人: BARBARA EDEN KLEIN
• 金额: $ 154.39万
• 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/8294242
• 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 treatment; 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