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High hemoglobin levels are associated with decreased risk of diabetic retinopathy in Korean type 2 diabetes.

ABSTRACT: Anemia is an independent risk factor for the development of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (DM). Hemoglobin levels may also be associated with DR. We investigated the association between hemoglobin levels and DR risk. This cross-sectional, population-based study utilized data from 2,123 type 2 DM patients aged ?30 years who participated in the Korea National Health and Nutrition Examination Survey from 2008 to 2012. Participants underwent an ophthalmic examination, including fundus photographs. A multiple logistic regression analysis was performed to evaluate the relationship between hemoglobin levels and DR risk. The mean hemoglobin levels in patients with and without DR were 13.76?±?0.12 and 14.33?±?0.05?g/dL, respectively, with anemia observed in 16.2 (2.4)% and 7.8 (0.8)%, respectively. A 19% decrease in DR risk was found with a 1.0-g/dL increase in hemoglobin level. DR risk exhibited a decreasing trend with increasing hemoglobin levels (P for trend <0.0001). The adjusted odds ratio of DR was significantly lower in the highest hemoglobin quartile. Our findings indicate that high hemoglobin levels are significantly related to a decreased DR risk in Korean type 2 diabetes.

SUBMITTER: Lee MK

PROVIDER: S-EPMC5882879 | biostudies-other | 2018 Apr

REPOSITORIES: biostudies-other

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High hemoglobin levels are associated with decreased risk of diabetic retinopathy in Korean type 2 diabetes.

Lee Min-Kyung MK Han Kyung-Do KD Lee Jae-Hyuk JH Sohn Seo-Young SY Jeong Jee-Sun JS Kim Mee-Kyoung MK Baek Ki-Hyun KH Song Ki-Ho KH Kwon Hyuk-Sang HS

Scientific reports 20180403 1

Anemia is an independent risk factor for the development of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (DM). Hemoglobin levels may also be associated with DR. We investigated the association between hemoglobin levels and DR risk. This cross-sectional, population-based study utilized data from 2,123 type 2 DM patients aged ≥30 years who participated in the Korea National Health and Nutrition Examination Survey from 2008 to 2012. Participants underwent an ophthalmic examin ...[more]

PMID: 29615813

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Project description:BackgroundDiabetic retinopathy (DR) is the primary oculopathy causing blindness in diabetic patients. Currently, there is increasing interest in the role of lipids in the development of diabetic retinopathy, but it remains controversial. Remnant cholesterol (RC) is an inexpensive and easily measurable lipid parameter; however, the relationship between RC and DR in type 2 diabetes mellitus (T2DM) has not been elucidated. This research investigates the relevance between RC levels and DR severity while building a risk prediction model about DR.MethodsIn this single-centre retrospective cross-sectional study. Each hospitalised T2DM patient had no oral lipid-lowering drugs in the past three months, and coronary angiography showed epicardial coronary artery stenosis of less than 50% and completed seven-field stereo photographs, fluorescein fundus angiography, and optical coherence tomography detection. The RC value is calculated according to the internationally recognised formula. Binary logistic regression was used to correct confounding factors, and the receiver operating characteristic (ROC) analysis was used to identify risk factors and assess the nomogram's diagnostic efficiency.ResultsA total of 456 T2DM patients were included in the study. The RC levels in the DR team was higher [0.74 (0.60-1.12) mmo/l vs 0.54 (0.31-0.83) mmol/l P < 0.001] in the non-DR team. After adjusting for confounding elements, RC levels are still associated with DR risk (OR = 5.623 95%CI: 2.996-10.556 P < 0.001). The ratio of DR in every stage (except mild non-proliferative diabetic retinopathy) and DME in the high RC level team were further increased compared to the low-level team (all P < 0.001). After ROC analysis, the overall risk of DR was predicted by a nomogram constructed for RC, diabetes duration, and the neutrophil-lymphocyte ratio as 0.758 (95%CI 0.714-0.802 P < 0.001).ConclusionsHigh RC levels may be a potential risk factor for diabetic retinopathy, and the nomogram does better predict DR. Despite these essential findings, the limitation of this study is that it is single-centred and small sample size analysis.

Project description:Purpose:To assess the relationship between metformin use and the severity of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM) and to investigate the effect of metformin dosage on reducing the incidence of DR. Methods:The study population included patients with newly diagnosed T2DM, who were aged ?20 years and prescribed with antidiabetic drug therapy lasting ?90 days, as identified using the National Health Insurance Research Database between 2000 and 2012. We matched metformin users and nonusers by a propensity score. Cox proportional hazard regression analyses were used to compute and compare the risk of developing nonproliferative diabetic retinopathy (NPDR) in metformin users and nonusers. Results:Overall, 10,044 T2DM patients were enrolled. Metformin treatment was associated with a lower risk of NPDR (aHR 0.76, 95% CI 0.68-0.87) and sight-threatening diabetic retinopathy (STDR, aHR 0.29, 95% CI 0.19-0.45); however, the reduction in risk was borderline significant for STDR progression among NPDR patients (aHR 0.54, 95% CI 0.28-1.01). Combination therapy of metformin and DPP-4i exhibited a stronger but inverse relationship with NPDR development (aHR 0.32, 95% CI 0.25-0.41), especially at early (<3 months) stages of metformin prescription. These inverse relationships were also evident at different metformin doses and in adapted Diabetes Complications Severity Index scores (aDCSI). Moreover, combination therapy of metformin with sulfonylureas was associated with an increased risk of NPDR. Conclusion:Metformin treatment in patients with T2DM was associated with a reduced risk of NPDR, and a potential trend was found for a reduced STDR risk in patients who had previously been diagnosed with NPDR. Combining metformin with DPP-4i seemingly had a significantly beneficial effect against NPDR risk, particularly when aDCSI scores were low, and when metformin was prescribed early after T2DM diagnosis. These results may recommend metformin for early treatment of T2DM.

Project description:BackgroundIncreased serum carcinoembryonic antigen (CEA) levels are reported to be associated with various metabolic and inflammatory diseases. This study assessed whether high-normal serum CEA is related to diabetic peripheral neuropathy (DPN) in patients with type 2 diabetes (T2D).MethodsAll subjects received DPN assessment based on neuropathic symptoms, neuropathic signs, and nerve conduction studies to calculate composite Z scores of nerve latency, amplitude and conduction velocity (NCV). DPN was confirmed by both at least a presentation of neuropathic symptoms/signs and an abnormal nerve conduction index. Serum CEA levels and other clinical indices were also synchronously detected. Multivariable linear regression analyses were used to determine the independent effects of serum CEA levels on nerve conduction indices, multivariable logistic regression analyses were used to determine the independent impact of CEA levels on the risk of DPN, and receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic capability of CEA levels to discriminate DPN.ResultsWe ultimately recruited 402 eligible subjects with normal ranges of serum CEA for this study, and 25.4% (n = 102) were determined to have DPN. After adjusting for other clinical covariates, serum CEA levels were independently associated with the composite Z score for latency (β = 0.132, t = 2.330, p = 0.021), amplitude (β = - 0.164, t = - 2.838, p = 0.005) and NCV (β = - 0.210, t = - 3.662, p < 0.001). Moreover, the prevalence of DPN in the first, second, third and fourth quartiles of CEA level was 12.9%, 19.0%, 29.4% and 40.4%, respectively (p for trend < 0.001); the corresponding adjusted odds ratios and 95% CIs for DPN in CEA quartiles were 1, 1.47 (0.45-4.82), 1.72 (0.54-5.53) and 4.58 (1.39-15.06), respectively. Furthermore, the optimal cut-off value of high-normal serum CEA to discriminate DPN was ≥ 2.66 ng/mL, with a Youden index of 0.28, sensitivity of 66.67% and specificity of 61.00%.ConclusionsIncreased serum CEA levels within the normal range are closely linked to dysfunction of peripheral nerve conduction and the risk of DPN, and high-normal serum CEA levels are a potential risk factor for DPN in T2D.

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High hemoglobin levels are associated with decreased risk of diabetic retinopathy in Korean type 2 diabetes.

Publications

High hemoglobin levels are associated with decreased risk of diabetic retinopathy in Korean type 2 diabetes.

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