PMID- 29985712
OWN - NLM
STAT- MEDLINE
DCOM- 20190304
LR  - 20200225
IS  - 1744-5086 (Electronic)
IS  - 0928-6586 (Print)
IS  - 0928-6586 (Linking)
VI  - 25
IP  - 5-6
DP  - 2018 Oct-Dec
TI  - Neural dysfunction and retinopathy in persons with type 1 diabetes.
PG  - 373-378
LID - 10.1080/09286586.2018.1489971 [doi]
AB  - OBJECTIVE: To determine associations of microvascular and neuropathic 
      complications of diabetes cross-sectionally and longitudinally in persons with 
      long-term type 1 diabetes (T1D). RESEARCH DESIGN AND METHODS: Persons receiving 
      care for T1D in South Central Wisconsin were identified in 1979-1980 and examined 
      approximately every 5 years. Associations between neuropathic and microvascular 
      complications were examined at most prior visits, when information on several 
      neuropathic complications was collected. Temporal relationships were examined by 
      modeling incidence between examinations across the visits. RESULTS: Adjusting for 
      duration of diabetes, glycated hemoglobin, and systolic blood pressure, the 
      following were cross-sectionally associated with prevalent PDR (proliferative 
      diabetic retinopathy): the presence of sensory neuropathy (SN) as reported at 
      each Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR) examination 
      (odds ratio (OR) = 2.76, confidence interval (CI) = 1.71, 4.48) and the heartrate 
      variability measures RMSD (square root of the mean of squared differences of 
      successive RR intervals) (OR = 0.24, CI = 0.16, 0.37) and SDNN (standard 
      deviation of successive RR intervals) (OR = 0.26, CI = 0.17, 0.39). Findings were 
      similar for prevalent ME (macular edema) as assessed from spectral-domain optical 
      coherence tomography (SD-OCT). The presence of PDR (OR = 2.13, CI = 1.63, 2.78) 
      and ME (OR = 2.36, CI = 1.66, 3.34) were both significantly associated with 
      incident WESDR SN. WESDR SN was associated with incident PDR (OR = 1.53, 
      CI = 1.09, 2.15) but not incident ME (OR = 1.31, CI = 0.92, 1.87). CONCLUSIONS: 
      Sensory neuropathy and heartrate variability were significantly associated with 
      prevalent PDR and ME in people with long-term T1D. PDR and ME were significantly 
      associated with incident sensory neuropathy, and sensory neuropathy was 
      significantly associated with incident PDR. Studies using earliest detectable 
      markers of microvascular and neurologic abnormalities are needed to determine 
      which of the two systems 'fails' first. Such information might suggest a temporal 
      sequence of diabetes complications.
FAU - Klein, Barbara E K
AU  - Klein BEK
AD  - a Ophthalmology & Visual Sciences , University of Wisconsin-Madison , Madison , 
      WI , USA.
FAU - Horak, Kayla L
AU  - Horak KL
AD  - a Ophthalmology & Visual Sciences , University of Wisconsin-Madison , Madison , 
      WI , USA.
FAU - Lee, Kristine E
AU  - Lee KE
AD  - a Ophthalmology & Visual Sciences , University of Wisconsin-Madison , Madison , 
      WI , USA.
FAU - Meuer, Stacy M
AU  - Meuer SM
AD  - a Ophthalmology & Visual Sciences , University of Wisconsin-Madison , Madison , 
      WI , USA.
FAU - Abramoff, Michael D
AU  - Abramoff MD
AD  - b Electrical and Computer Engineering , University of Iowa , Iowa City , IA , 
      USA.
AD  - c Biomedical Engineering , University of Iowa , Iowa City , IA , USA.
FAU - Soliman, Elsayed Z
AU  - Soliman EZ
AD  - d Epidemiology & Prevention EpiCare , Wake Forest University , Winston-Salem , NC 
      , USA.
FAU - Rechek, Mary
AU  - Rechek M
AD  - a Ophthalmology & Visual Sciences , University of Wisconsin-Madison , Madison , 
      WI , USA.
FAU - Klein, Ronald
AU  - Klein R
AD  - a Ophthalmology & Visual Sciences , University of Wisconsin-Madison , Madison , 
      WI , USA.
LA  - eng
GR  - R01 EY016379/EY/NEI NIH HHS/United States
GR  - EY016379/NH/NIH HHS/United States
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, N.I.H., Extramural
DEP - 20180709
PL  - England
TA  - Ophthalmic Epidemiol
JT  - Ophthalmic epidemiology
JID - 9435674
SB  - IM
MH  - Diabetes Mellitus, Type 1/*complications
MH  - Diabetic Retinopathy/*complications/epidemiology/physiopathology
MH  - Disease Progression
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Incidence
MH  - Macular Edema/epidemiology/*etiology/physiopathology
MH  - Male
MH  - Prevalence
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Time Factors
MH  - *Visual Acuity
MH  - Wisconsin/epidemiology
PMC - PMC6411294
MID - NIHMS1514726
COIS- Conflicts of Interest: None of the authors has any conflicts of interest to 
      disclose.
EDAT- 2018/07/10 06:00
MHDA- 2019/03/05 06:00
PMCR- 2019/10/01
CRDT- 2018/07/10 06:00
PHST- 2018/07/10 06:00 [pubmed]
PHST- 2019/03/05 06:00 [medline]
PHST- 2018/07/10 06:00 [entrez]
PHST- 2019/10/01 00:00 [pmc-release]
AID - 10.1080/09286586.2018.1489971 [doi]
PST - ppublish
SO  - Ophthalmic Epidemiol. 2018 Oct-Dec;25(5-6):373-378. doi: 
      10.1080/09286586.2018.1489971. Epub 2018 Jul 9.