Retinal Vascular Geometry Predicts Incident Renal Dysfunction in Young People with Type 1

Diabetes

Featured Article:

Paul Z. Benitez-Aguirre, M.P.H., FRACP., Muhammad Bayu Sasongko, M.D., MEPI, Maria E. Craig, FRACP, Ph.D., Alicia J. Jenkins, M.D., Janine Cusumano, R.N., Ning Cheung, MBBS Tien Yin Wong, M.D., Ph.D., Kim C. Donaghue, FRACP, Ph.D.

Diabetes Care Volume 36: 599-604

March, 2012

Study Objective

• To examine the relationship between retinal vascular geometry parameters and development of incident renal dysfunction in young people with type 1 diabetes

Benitez-Aguirre C et al. Diabetes Care 2012;36:599-604

Study Design

•Prospective cohort study of 511 adolescents with type 1 diabetes of at least 2 years duration, with normal albumin excretion rate (AER) and no retinopathy at baseline  •AER quantified over median of 3.7 years of follow-up by overnight, timed urine specimen collections and early renal dysfunction defined as AER >7.5 mg/min •Retinal vascular geometry (including length-to-diameter ratio [LDR] and simple tortuosity [ST]) quantified from baseline retinal potographs •Generalized estimating equations were used to examine the relationship between incident renal dysfunction and baseline venular LDR and ST, adjusting for age, diabetes duration, glycated hemoglobin (A1C), blood pressure (BP), BMI, and cholesterol

Benitez-Aguirre C et al. Diabetes Care 2012;36:599-604

Benitez-Aguirre C et al. Diabetes Care 2012;36:599-604

Benitez-Aguirre C et al. Diabetes Care 2012;36:599-604

Benitez-Aguirre C et al. Diabetes Care 2012;36:599-604

Conclusions

•Retinal venular geometry independently predicted incident renal dysfunction in young people with type 1 diabetes •These noninvasive retinal measures may help to elucidate early mechanistic pathways for microvascular complications •Retinal venular geometry may be a useful tool to identify individuals at high risk of renal disease early in the course of diabetes

Benitez-Aguirre C et al. Diabetes Care 2012;36:599-604