Association of retinopathy severity with cardiovascular and renal outcomes in patients with type 1 diabetes: a multi-state modeling analysis

• Published in: Scientific reports 2022-03, Vol.12 (1), p.4177-4177, Article 4177
• Main Authors: Wang, Wei-Ming, Ou, Huang-Tz, Wen, Miin-Jye, Su, Pei-Fang, Yang, Chen-Yi, Kuo, Te-Hui, Wang, Ming-Cheng, Lin, Wei-Hung
• Format: Article
• Language: English
• Subjects: 692/163; 692/4022; 692/499; Diabetes; Diabetes mellitus (insulin dependent); Diabetic retinopathy; End-stage renal disease; Humanities and Social Sciences; Kidney diseases; multidisciplinary; Retinopathy; Science; Science (multidisciplinary)
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-022-08166-4

This study aimed to assess the impact of diabetic retinopathy (DR) severity on the incidence of major adverse cardiac events (MACE) and end-stage renal disease (ESRD) in T1D patients. Patients diagnosed with T1D between 1999 and 2013 were identified from patient-level data of Taiwan’s National Health Insurance Research database. A total of 1135 patients were included and classified into mild DR (n = 454), severe DR (n = 227), or non-DR (n = 454) by using propensity score matching. Multi-state model analyses, an extension of competing risk models with adjustment for transition-specific covariates for prediction of subsequent MACE and ESRD, were performed. MACE and ESRD risks were significantly higher in the severe DR patients; a 2.97-fold (1.73, 5.07) and 12.29-fold (6.50, 23.23) increase in the MACE risk among the severe DR patients compared to the mild DR and DR-free patients, respectively; and, a 5.91-fold (3.50, 9.99) and 82.31-fold (29.07, 233.04) greater ESRD risk of severe DR patients than that of the mild DR and DR-free groups, respectively ( p