Early Onset Age Increased the Risk of Diabetic Retinopathy in Type 2 Diabetes Patients with Duration of 10-20 Years and HbA1C ≥7%: A Hospital-Based Case-Control Study.

Jing Yuan,Jin-Kui Yang,Pu Jia,Zhong Xin,Lin Zhang,Xiaojing Ma

doi:10.1155/2021/5539654

Abstract

Background The relationship between onset age of diabetes and diabetic retinopathy (DR) is controversy and not concluded. Therefore, this hospital-based case-control study aimed to investigate the influence of diabetes onset age on the development of DR in patients with type 2 diabetes (T2D), independent of diabetic duration and HbA1c levels. Methods A sample of 780 T2D patients with diabetic duration of 10–20 years and glycated hemoglobin (HbA1c) ≥7% were enrolled in the study. 338 T2D patients with onset age ≤45 years were further selected as cases (early onset) and 79 with onset age ≥ 55 years were chosen as controls (elderly onset). International Clinical Diabetic Retinopathy Disease Severity Scale was applied to estimate the severity of DR. Results The prevalence of DR and proliferative diabetic retinopathy (PDR) was notably increased in the early onset group. When stratified by duration of diabetes, the impact of younger age on the risk of DR turned to be greatest in patients with diabetic duration ≥15 years (OR = 5.202, 95% CI 2.625–10.310). In groups stratified by HbA1c, the risk of DR was highest in patients with younger onset age and HbA1c ≥ 9% (OR = 3.889, 95% CI 1.852–8.167). Compared with the elderly onset group, the risk of DR (OR = 1.776, 95% CI = 1.326–2.380, p < 0.001) and PDR (OR = 1.605, 95% CI = 1.106–2.329, p = 0.013) in younger diagnosed patients was increased after multivariable adjustment. Conclusions Age of onset was an independent risk factor for developing DR and PDR. This suggests that it is urgent to closely monitor and treat the metabolic disorders in younger T2D patients to delay the occurrence and progression of DR.

Highlights

Diabetic retinopathy (DR) is a prevalent and important microvascular complication of diabetes and widely considered as a major risk factor for vison loss and vison impairment in working-aged adults [1, 2], which could lead to decreased quality of life and increased financial burden of society
More patients in the early onset group were treated by insulin (p < 0.001). ere were no significant differences in sex, Body mass index (BMI), HbA1c, C-peptide, Fasting blood glucose (FBG), and uric acid (UA) (p > 0.05)
BMI, body mass index; HbA1c, glycated hemoglobin; FBG, fasting blood glucose; SBP, systolic blood pressure; DBP, diastolic blood pressure; Scr, serum creatinine; UA, uric acid; ALT, alanine aminotransferase; AST, aspartate aminotransferase; TC, total cholesterol; TG, triglycerides; LDL, low-density lipoprotein; GLP-1RA, GLP-1 receptor agonist; DR, diabetic retinopathy; PDR, proliferative diabetic retinopathy. In this hospital-based case-control study with type 2 diabetes (T2D) patients of diabetic duration 10–20 years and HbA1c ≥ 7%, we demonstrated that the prevalence of DR and PDR was significantly higher in early onset T2D patients (≤45 years) than in elderly onset T2D patients (≥55 years)

Summary

Introduction

Diabetic retinopathy (DR) is a prevalent and important microvascular complication of diabetes and widely considered as a major risk factor for vison loss and vison impairment in working-aged adults [1, 2], which could lead to decreased quality of life and increased financial burden of society. Previous studies [4,5,6,7] have already offered insights that hyperglycemia and long duration of diabetes are well-known risk factors in the development and progression of DR. Other risk factors, such as hypertension [8]. Some studies reported that patients with early onset diabetes and with longer diabetic duration [10] or higher HbA1c [11] had an increased prevalence of DR. Another study indicated that type 2 diabetes (T2D) patients with onset age of 31–45 years, not ≤30 years, had the highest susceptibility to DR [12]. To the best of our knowledge, a casecontrol study is not applied to date to minimize the influence of diabetic duration and glycemic control

Methods

Results

Conclusion