Retinal Vessel Biomarkers for Risk Assessment of Incident Diabetic Complications in the WESDR

WESDR 中用于糖尿病并发症风险评估的视网膜血管生物标志物

• 批准号: 8833707
• 负责人: RONALD KLEIN
• 金额: $ 99.43万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-30 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8833707
• 关键词: Address; Advanced Glycosylation End Products; Amputation; Antihypertensive Agents; Appearance; Area; Biological Markers; Blood Pressure; Caliber; Cardiovascular Diseases; Caring; Characteristics; Charge; Clinical; Cohort Studies; Complications of Diabetes Mellitus; Computer software; County; Data; Data Sources; Daughter; Development; Diabetes Mellitus; Diabetic Nephropathy; Diabetic Retinopathy; Digestive System Disorders; Dimensions; Early Diagnosis; Epidemiologic Studies; Epidemiology; Eye; Fractals; Frequencies; Funding; Fundus; Glycosylated Hemoglobin; Goals; Grant; Guidelines; Incidence; Institutes; Insulin; Insulin-Dependent Diabetes Mellitus; Intervention; Kidney Diseases; Lead; Length; Life; Lipids; Lower Extremity; Measurement; Measures; Medical; Modeling; Morbidity - disease rate; Myocardial Infarction; National Eye Institute; Natural History; Nature; Neuropathy; Non-Insulin-Dependent Diabetes Mellitus; Oxidative Stress; Parents; Patients; Pattern; Persons; Physicians; Predictive Value; Preventive; Protocols documentation; Public Health; Receiver Operating Characteristics; Relative (related person); Request for Applications; Retinal; Retinal Diseases; Risk; Risk Assessment; Risk Factors; Role; Serum; Smoking; Stroke; Vision; Visit; Wisconsin; base; blood pressure regulation; clinically significant; cohort; diabetic; diabetic patient; experience; follow-up; high risk; improved; indexing; macular edema; mortality; non-diabetic; prevent; proliferative diabetic retinopathy; prospective; public health relevance; retina blood vessel structure; screening; type I and type II diabetes

 DESCRIPTION (provided by applicant): Persons with diabetes mellitus are at high risk of developing severe complications, presenting a pressing need to prevent them from occurring. It is, therefore, the goal of this epidemiological study to determine the long term relationships of retinal vessel geometric characteristics (such as tortuosity, branching angles, junctional coefficients, fractals, length to diameter ratio) to the incidence of diabetic retinopathy and its progression to severe vision-threatening retinopathy (proliferative diabetic retinopathy and macular edema) as well as to the incidence of systemic complications including diabetic nephropathy, lower extremity amputation, myocardial infarction, and stroke, adjusting for glycemic and blood pressure control and other confounders. A second goal is to determine whether these retinal vessel geometric characteristics can be used for risk assessment for predicting the incidence of early and severe diabetic complications. This proposal builds upon the findings of the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR, funded by NEI grant R01 EY016379), a longitudinal representative cohort study of persons with type 1 and type 2 diabetes. The study includes all insulin-taking persons with type 1 diabetes (n=996) and type 2 diabetes (n=1370) who were receiving primary medical care in an 11-county area of southwestern Wisconsin in 1979-1980 and who were examined in 1980-1982. The cohort was reexamined approximately every 5 years thereafter, with persons with type 1 diabetes participating in up to 7 examinations over a 33-year period and those with type 2 diabetes participating in up to 3 visits over a 10-year period. Retinal vessel geometric characteristics wil be measured from digitized photographs taken at the examinations. The new data from this study will provide a unique opportunity to determine whether changes in these retinal vessel geometric measures can be used as biomarkers to predict the incidence of diabetic complications, and to examine their utility as biomarkers for risk assessment. These data will be important to patients and their physicians for managing their diabetes and to public health practitioners recommending approaches to assess risk and deliver preventive care based on these assessments.

 描述（由申请人提供）：糖尿病患者发生严重并发症的风险很高，迫切需要预防这些并发症的发生。因此，本流行病学研究的目的是确定视网膜血管几何特征的长期关系（例如弯曲度、分支角、连接系数、分形，长度直径比）与糖尿病视网膜病变的发病率及其进展为严重的视力威胁性视网膜病变的关系（增殖性糖尿病视网膜病变和黄斑水肿）以及包括糖尿病肾病、下肢截肢、心肌梗死和中风的全身性并发症的发生率，调整血糖和血压控制以及其他混杂因素。第二个目标是确定这些视网膜血管几何特征是否可用于预测早期和严重糖尿病并发症发生率的风险评估。该提案基于威斯康星州糖尿病视网膜病变流行病学研究（WESDR，由NEI资助R 01 EY 016379）的发现，该研究是1型和2型糖尿病患者的纵向代表性队列研究。这项研究包括所有服用胰岛素的1型糖尿病患者（n=996）和2型糖尿病患者（n=1370），他们在1979-1980年期间在威斯康星州西南部的11个县接受初级医疗保健，并在1980-1982年接受检查。此后大约每5年对该队列进行一次复查，1型糖尿病患者在33年内参加了多达7次检查，2型糖尿病患者在10年内参加了多达3次检查。视网膜血管几何特征将从检查时拍摄的数字化照片中测量。这项研究的新数据将提供一个独特的机会，以确定这些视网膜血管几何测量的变化是否可以用作预测糖尿病并发症发生率的生物标志物，并检查其作为风险评估生物标志物的效用。这些数据对于患者及其医生管理糖尿病以及公共卫生从业者建议评估风险并根据这些评估提供预防性护理的方法非常重要。