PSUN167 Diabetic retinopathy and diabetes-related renal disease, either isolated or both associated, and the impact on the 10-year risk of cardiovascular disease: are we dealing with similar conditions?

Abstract

Abstract Diabetes complications, which includes diabetes-related renal disease (DRD) and retinopathy (DR), may result in worse quality of life, disability and premature death, mainly due to cardiovascular disease. In this context, there has been a growing focus on diabetes-related complications and their impact on chronic outcomes. To assess the association between DR, DRD and the 10-year risk of atherosclerotic cardiovascular disease in patients with diabetes. A cross-sectional study was performed including patients with type 1 diabetes (T1DM) and type 2 diabetes (T2DM) under outpatient follow-up in Southern Brazil. Participants’ data were extracted from medical records between 2019 to 2020. Patients included were stratified into 4 groups: G1(no diabetes-related complications); G2 (RD only); G3 (DRD only); G4 (presence of both RD and DRD). The presence of RD was defined as any alteration related to diabetes identified using a retinal scanning device in the period. For DRD, the presence of reduced estimated glomerular filtration rateand/or albuminuria was considered. The primary outcome was the 10-year risk assessment of cardiovascular events based on the American Heart Association ASCVD score. One-way ANOVA with post hoc Tukey test was used for comparisons. A total of 571 patients were included, of which 128 had T1DM (mean age of 39.4 ± 15.1 years and 48.4% were women) and 443 had T2DM (mean age of 59.5 ± 11.9 years and 66.4% were women). Among T1DM participants, the 10-year risk of a cardiovascular event was 6.1 ± 8.9% in the G1 (124, no diabetes-related complications), 8.9 ± 11.8% in the G2 (54, with RD), 5.4 ± 8.8% in the G3 (149, with DRD), and 6.1 ± 9.5% in the G4 (n=116, with RD and DRD). The mean difference between the groups was not significant. Among T2DM participants, the 10-year risk of a cardiovascular event was 15.2 ± 14.6% in the G1, 15.7 ± 10.7% in the G2, 22.5 ± 16.7% in the G3, and 21.5 ± 15.1% in the G4, reflecting a significantly higher cardiovascular risk in the groups with renal involvement (P <0.001). Post hoc analyses showed that the G3 (with DRD) and G4 (with RD and DRD) had a higher 10-year cardiovascular risk compared to the groups without complications and with RD isolated. This difference persists even when corrected for age, sex, ACE inhibitors use and hypertension [R +4.7 (1.2 a 8.4)and R +3.8 (0.01 a 7.6) in the G3 and G4, respectively]. In T2DM, the presence of specific microvascular complications affects the 10-year cardiovascular risk differently, and the renal involvement seems to be associated with a greater theoretical cardiovascular risk when compared to the presence of RD alone. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.