PMID- 33351059 OWN - NLM STAT- MEDLINE DCOM- 20210512 LR - 20210512 IS - 1552-5783 (Electronic) IS - 0146-0404 (Print) IS - 0146-0404 (Linking) VI - 61 IP - 14 DP - 2020 Dec 1 TI - Anemia and Diabetic Kidney Disease Had Joint Effect on Diabetic Retinopathy Among Patients With Type 2 Diabetes. PG - 25 LID - 10.1167/iovs.61.14.25 [doi] LID - 25 AB - PURPOSE: Whether the association between diabetic kidney disease (DKD) and diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM) is leveraged by anemia remains unclear. This study is to evaluate the joint effect of DKD and anemia on DR. METHODS: Data were collected from electronic medical records of 1389 patients with T2DM in the Yiwu Central Hospital of Zhejiang Province from 2018 to 2019. Based on retinal examination findings, patients were classified as without diabetic retinopathy (non-DR), non-proliferative diabetic retinopathy (NPDR), and proliferative diabetic retinopathy (PDR). Odds ratio (OR) from multinomial logistic regression models adjusting for potential risk factors of DR were used to evaluate associations of DKD, renal function measures, and anemia with risk of NPDR and PDR. Path analysis was performed to help understand the association of DKD and hemoglobin (Hb) with DR. RESULTS: The study included 901 patients with non-DR, 367 patients with NPDR and 121 patients with PDR. Both high DKD risk and abnormal renal function measures were significantly associated with PDR. Anemia was associated with increased risk of NPDR (OR = 1.75, 95% confidence interval [CI] = 1.18-2.58) and PDR (OR = 3.71, 95% CI = 2.23-6.18). DKD severity and anemia had joint effect on NPDR (OR = 2.29, 95% CI = 1.32-3.96) and PDR (OR = 11.31, 95% CI = 5.95-21.51). These associations were supported by path analysis. CONCLUSIONS: DKD severity, abnormal estimated glomerular filtration rate (eGFR), and urinary albumin/creatinine ratio (UACR) were associated with increased risk of DR in patients with T2DM, and anemia had joint effect on these associations. Improving Hb level may decrease the risk of DR in patients with T2DM. FAU - Wang, Jianyong AU - Wang J AD - Department of Ophthalmology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China. FAU - Xin, Xing AU - Xin X AD - Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. AD - Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China. FAU - Luo, Wenliang AU - Luo W AD - Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. AD - Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China. FAU - Wang, Ruojie AU - Wang R AD - Department of Ophthalmology, Central Hospital of Yiwu City, Yiwu, China. FAU - Wang, Xinyi AU - Wang X AD - Yuanpei College, Peking University, Beijing, China. FAU - Si, Shuting AU - Si S AD - Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. AD - Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China. FAU - Mo, Minjia AU - Mo M AD - Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. AD - Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China. FAU - Shao, Bule AU - Shao B AD - Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. AD - Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China. FAU - Wang, Shuojia AU - Wang S AD - Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. AD - Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China. FAU - Shen, Yu AU - Shen Y AD - Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. AD - Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China. FAU - Chen, Xi AU - Chen X AD - Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. AD - Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China. FAU - Yu, Yunxian AU - Yu Y AD - Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. AD - Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - United States TA - Invest Ophthalmol Vis Sci JT - Investigative ophthalmology & visual science JID - 7703701 RN - 0 (Hemoglobins) SB - IM MH - Anemia/*complications MH - Cross-Sectional Studies MH - Diabetes Mellitus, Type 2/*complications MH - Diabetic Nephropathies/*complications MH - Diabetic Retinopathy/*etiology MH - Female MH - Hemoglobins/analysis MH - Humans MH - Male MH - Middle Aged MH - Retrospective Studies MH - Risk Factors PMC - PMC7757636 COIS- Disclosure: J. Wang, None; X. Xin, None; W. Luo, None; R. Wang, None; X. Wang, None; S. Si, None; M. Mo, None; B. Shao, None; S. Wang, None; Y. Shen, None; X. Chen, None; Y. Yu, None EDAT- 2020/12/23 06:00 MHDA- 2021/05/13 06:00 PMCR- 2020/12/22 CRDT- 2020/12/22 12:37 PHST- 2020/12/22 12:37 [entrez] PHST- 2020/12/23 06:00 [pubmed] PHST- 2021/05/13 06:00 [medline] PHST- 2020/12/22 00:00 [pmc-release] AID - 2772097 [pii] AID - IOVS-20-31305 [pii] AID - 10.1167/iovs.61.14.25 [doi] PST - ppublish SO - Invest Ophthalmol Vis Sci. 2020 Dec 1;61(14):25. doi: 10.1167/iovs.61.14.25.