scholarly journals Detection of perimacular red dots and blots when screening for diabetic retinopathy: Refer or not refer?

2018 ◽  
Vol 15 (4) ◽  
pp. 356-359 ◽  
Author(s):  
Anatolie Baltatescu ◽  
Elio Striglia ◽  
Marina Trento ◽  
Aurora Mazzeo ◽  
Franco Cavallo ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Diabetic Retinopathy ◽  
Risk Factor ◽  
Independent Risk Factor ◽  
Disease Duration ◽  
Multivariate Model ◽  
The Other ◽  
Haemoglobin A1c ◽  
Disc Diameter ◽  
Baseline Haemoglobin

Purpose: Detection of microaneurysms and/or microhaemorrhages near the fovea when screening for diabetic retinopathy poses a problem because referral to retinal specialists may alarm patients and unnecessarily burden ophthalmologists. Methods: Six-month prospective study of patients found to have minimal red lesions within one disc diameter of the fovea when screened for diabetic retinopathy. Two 45° digital photographs, one centred on the macula and the other nasal including the optic disc, were taken for each eye. All patients received a 6-month re-screening appointment. Results: Out of 70 patients, 41 returned for re-screening. Diabetic retinopathy had worsened in 3 who required referral but no treatment, was unchanged in 19 and was undetectable in the other 19. Haemoglobin A1c decreased from 7.76% ± 1.50% (61.3 ± 16.2 mmol/mol) to 6.93% ± 1.7% (52.3 ± 18.9 mmol/mol) in the patients in whom diabetic retinopathy worsened but did not change in the other groups. Baseline haemoglobin A1c ( p = 0.048) and systolic blood pressure ( p = 0.007) were lower in the patients in whom diabetic retinopathy improved, but a multivariate model including haemoglobin A1c, blood pressure and known disease duration could not identify any independent risk factor. Conclusion: Minimal red lesions near the fovea, though commanding early re-screening, do not require immediate referral to retinal specialists.

Retinal oxygen saturation is an independent risk factor for the severity of diabetic retinopathy

2018 ◽  
Vol 103 (8) ◽  
pp. 1167-1172 ◽  
Author(s):  
Toke Bek ◽  
Einar Stefánsson ◽  
Sveinn Hákon Hardarson
Keyword(s):  
Risk Factors ◽  
Diabetic Retinopathy ◽  
Risk Factor ◽  
Oxygen Saturation ◽  
Independent Risk Factor ◽  
Haemoglobin A1c ◽  
Retinal Arterioles ◽  
Explained Variation ◽  
Endothelial Growth Factor ◽  
Growth Factor Treatment

BackgroundThe oxygen saturation in larger retinal vessels has been shown to increase with increasing diabetic retinopathy (DR) grade and to help predict the effect of antivascular endothelial growth factor treatment in patients with diabetic maculopathy. However, it is unknown to what extent the increased oxygen saturation co-varies with other risk factors and whether it is an independent risk factor for the severity of DR.MethodsSeven hundred and twenty-two successive patients referred for specialist evaluation of diabetic retinopathy including retinal oximetry were studied. Multiple regression analysis was used to investigate whether oxygen saturation in the larger retinal arterioles and venules contributed to the severity of diabetic retinopathy, independently of gender, age, diabetes duration, diabetes type, body mass index, blood pressure, haemoglobin A1c, visual acuity and central retinal thickness.ResultsThe included parameters could explain less than 15% of the variation in retinopathy grade. Approximately, one-third of the explained variation was related to the retinal oxygen saturation.ConclusionsProspective studies are needed to evaluate whether retinal oxygen saturation is predictive for the development of diabetic retinopathy and how it interacts with other biomarkers and risk factors over time.

Abstract P146: Uric Acid is an Independent Risk Factor for Developing Hypertension From Prehypertension: A 5-year Japanese Cohort Study

Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Masanari Kuwabara ◽  
Shigeko Hara ◽  
Koichiro Niwa ◽  
Minoru Ohno ◽  
Ichiro Hisatome
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Blood Pressure ◽  
Body Mass Index ◽  
Uric Acid ◽  
Risk Factor ◽  
Cohort Study ◽  
Serum Uric Acid ◽  
Independent Risk Factor ◽  
Drinking Habits

Objectives: Prehypertension frequently progresses to hypertension and is associated with cardiovascular diseases, stroke, excess morbidity and mortality. However, the identical risk factors for developing hypertension from prehypertension are not clarified. This study is conducted to clarify the risks. Methods: We conducted a retrospective 5-year cohort study using the data from 3,584 prehypertensive Japanese adults (52.1±11.0 years, 2,081 men) in 2004 and reevaluated it 5 years later. We calculated the cumulative incidences of hypertension over 5 years, then, we detected the risk factors and calculated odds ratios (ORs) for developing hypertension by crude analysis and after adjustments for age, sex, body mass index, smoking and drinking habits, baseline systolic and diastolic blood pressure, pulse rate, diabetes mellitus, dyslipidemia, chronic kidney disease, and serum uric acid. We also evaluated whether serum uric acid (hyperuricemia) provided an independent risk for developing hypertension. Results: The cumulative incidence of hypertension from prehypertension over 5 years was 25.3%, but there were no significant differences between women and men (24.4% vs 26.0%, p=0.28). The cumulative incidence of hypertension in subjects with hyperuricemia (n=726) was significantly higher than those without hyperuricemia (n=2,858) (30.7% vs 24.0%, p<0.001). After multivariable adjustments, the risk factors for developing hypertension from prehypertension were age (OR per 1 year increased: 1.023; 95% CI, 1.015-1.032), women (OR versus men: 1.595; 95% CI, 1.269-2.005), higher body mass index (OR per 1 kg/m 2 increased: 1.051; 95% CI 1.021-1.081), higher baseline systolic blood pressure (OR per 1 mmHg increased: 1.072; 95% CI, 1.055-1.089) and diastolic blood pressure (OR per 1 mmHg increased: 1.085; 95% CI, 1.065-1.106), and higher serum uric acid (OR pre 1 mg/dL increased: 1.149; 95% CI, 1.066-1.238), but not smoking and drinking habits, diabetes mellitus, dyslipidemia, and chronic kidney diseases. Conclusions: Increased serum uric acid is an independent risk factor for developing hypertension from prehypertension. Intervention studies are needed to clarify whether the treatments for hyperuricemia in prehypertensive subjects are useful.

scholarly journals Serum High Lipoprotein(a) Levels in Patients with Type 2 Diabetes May Be an Independent Risk Factor for Hypertension

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Lingfen Zeng ◽  
Jieming Sun ◽  
Ming Cui
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Risk Factor ◽  
Independent Risk Factor ◽  
Glycosylated Hemoglobin ◽  
Serum Triglyceride ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Lipoprotein A

Objective — To investigate whether serum lipoprotein(a) [Lp(a)] is an independent risk factor for abnormal blood pressure in patients with type 2 diabetes mellitus. Method — Analyzed data collected from diabetes patients and epidemiological survey from January 1,2020 to May 01,2021, with hypertension as a dependent variable, metabolic index such as glycosylated hemoglobin, serum total cholesterol, serum triglyceride and Lp(a) were independent variables, established logistic regression equation, analyze the influence of their variables on dependent variables. Results — The OR value of Lp(a) is 1.020, 95% confidence intervals (1.006, 1.035), p 0.006; The OR value of age is 1.073, 95% confidence interval (1.028, 1.119); and OR of the remaining parameters were tested no statistically different, p>0.05. Conclusions — The abnormal elevated Lp(a) level in the serum of type 2 diabetic patients may be related to the occurrence of hypertension. For patients with high Lp(a), Monitoring blood pressure may help to better detect and diagnose hypertension. At the same time, it is suggested that reducing serum Lp(a) level may reduce the risk of hypertension.

Cross-talk between ANGPTL4 gene SNP rs1044250 and weight management is a risk factor of Mets

2020 ◽  
Author(s):  
Zhoujie Tong ◽  
Jie Peng ◽  
Hongtao Lan ◽  
Wenwen Sai ◽  
Yulin Li ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Risk Factor ◽  
Waist Circumference ◽  
Weight Management ◽  
Independent Risk Factor ◽  
Lifestyle Changes ◽  
Elevated Blood Pressure ◽  
Base Line ◽  
Elevated Blood

Abstract Background The prevalence of metabolic syndrome (Mets) is closely related to the increased incidence of cardiovascular events. Angiopoietin-like protein 4 (ANGPTL4) is contributory to the regulation of lipid metabolism, herein, may provide a target for gene-aimed therapy of Mets. This case-control study was designed to elucidate the relationship between Angiopoietin-like protein 4 (ANGPTL4) gene single nucleotide polymorphism (SNP) rs1044250 and the onset of Mets, and to explore the effect of interaction between SNP rs1044250 and weight management on Mets. Methods We have recruited 1018 Mets cases and 1029 controls in this study. The SNP rs1044250 was detected, base-line information and Mets-related indicators were collected. A 5-year follow-up survey was carried out to track the lifestyle changes, drug treatments and changes in Mets-related indicators. Results ANGPTL4 gene SNP rs1044250 is an independent risk factor for increased waist circumference (OR 1.618, 95% CI [1.119–2.340]; p = 0.011) and elevated blood pressure (OR 1.323, 95% CI [1.002–1.747]; p = 0.048), the prevalence of Mets (OR 1.875, 95% CI [1.363–2.580]; p < 0.001) is increased. The follow-up survey shows that rs1044250 CC genotype patients with weight gain have an increased number of Mets components (M [Q1, Q3]: CC 1 (0, 1), CT + TT 0 [-1, 1]; p = 0.021); The interaction between SNP rs1044250 and weight management is a risk factor for increased SBP (β = 0.075, p < 0.001) and increased DBP (β = 0.097, p < 0.001), the synergistic effect is negative (S < 1). Conclusion ANGPTL4 gene SNP rs1044250 is an independent risk factor for increased waist circumference and elevated blood pressure, therefore, for Mets. Weight management that interacts negatively with ANGPTL4 polymorphism is an essential lifestyle intervention approach for elevated blood pressure.

scholarly journals Age is an Independent Risk Factor for the Early Morning Blood Pressure Surge in Patients Never-Treated for Hypertension

2009 ◽  
Vol 39 (8) ◽  
pp. 322 ◽  
Author(s):  
Dong-Hyeon Lee ◽  
Sang-Hyun Ihm ◽  
Ho-Joong Youn ◽  
Yun-Seok Choi ◽  
Chan-Seok Park ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Risk Factor ◽  
Independent Risk Factor ◽  
Early Morning ◽  
Morning Blood Pressure Surge ◽  
Morning Blood Pressure ◽  
Pressure Surge

scholarly journals Early Diabetic Nephropathy and Retinopathy in Patients with Type 1 Diabetes Mellitus Attending Sudan Childhood Diabetes Centre

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Hana Ahmed ◽  
Tayseer Elshaikh ◽  
Mohamed Abdullah
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 1 Diabetes ◽  
Diabetic Retinopathy ◽  
Risk Factor ◽  
Diabetic Nephropathy ◽  
Type 1 Diabetes Mellitus ◽  
Ethnic Group ◽  
Childhood Diabetes

Objective. Data on microvascular complications in children and adolescents with type 1 diabetes mellitus (T1DM) in Sudan are scarce. This study was aimed at determining the prevalence of diabetic nephropathy (DN) and retinopathy (DR) and their relationship to certain risk factors in children with T1DM attending the Sudan Childhood Diabetes Centre. Design and Methods. A clinic-based cross-sectional study of 100 patients with T1DM aged 10-18 years. Patients with disease duration exceeding 5 years if the onset of diabetes was prepubertal and 2 years if it was postpubertal were included. Relevant sociodemographic, clinical, and biochemical information was obtained. Blood pressure was measured. The patients were screened for DN and DR using urinary microalbumin estimation and fundus photography, respectively. Results. The frequency of microalbuminuria and diabetic retinopathy was 36% and 33%, respectively. Eleven percent had both retinopathy and microalbuminuria. Seven percent of the patients were found to be hypertensive. Patients with diabetic retinopathy had significantly higher HbA1c levels ( p = 0.009 ) and longer diabetes duration ( p = 0.02 ) than patients without retinopathy. Logistic regression showed that high HbA1c (odds ratio (OR) 0.83, confidence interval (CI) 0.68-1.00, p = 0.04 ), but not age, duration, ethnic group, BMI, blood pressure, and presence of nephropathy, was an independent risk factor for retinopathy. Likewise, high blood pressure (OR 6.89, CI 1.17-40.52, p = 0.03 ), but not age, duration, ethnic group, BMI, HbA1c, and presence of retinopathy, was a predictor for nephropathy. Conclusion. High prevalence of incipient DN and early stages of DR were observed in this study. Longer diabetes duration and higher HbA1c were associated with the presence of diabetic retinopathy. High blood pressure was a risk factor for DN. So regular screening for these complications and optimization of glycemic control are needed.

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