PMID- 37150692 OWN - NLM STAT- MEDLINE DCOM- 20230509 LR - 20230509 IS - 0376-2491 (Print) IS - 0376-2491 (Linking) VI - 103 IP - 18 DP - 2023 May 16 TI - [Correlation between morphological characteristics of retinal microvessels and diabetic kidney disease in patients with type 2 diabetes mellitus based on a machine learning model]. PG - 1393-1400 LID - 10.3760/cma.j.cn112137-20221023-02214 [doi] AB - Objective: To explore the correlation between the morphological characteristics of retinal microvessels and diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (T2DM). Methods: The clinical data and fundus photography of patients with T2DM treated in the First Affiliated Hospital of Zhengzhou University from January 2018 to December 2020 were retrospectively collected and analyzed. According to the presence of abnormal renal function, the patients were divided into DKD group and control group. The morphology and structure of fundus vessels were digitized by U-Net depth convolution neural network, and the correlation between fundus vascular morphology and DKD was analyzed by multivariate logistic regression. Results: A total of 648 patients with T2DM were enrolled, including 410 males and 238 females, and aged (53+/-10) years. There were 398 and 250 cases in control and DKD groups, respectively. Meanwhile, 1 296 fundus images were collected. Compared with control group, the male ratio (68.4% vs 60.1%, P=0.032), age [(54+/-9) vs (52+/-10) years, P=0.005], blood pressure [(136.8+/-17.3) vs (130.3+/-15.4) mmHg（1 mmHg=0.133 kPa）, P<0.001], total cholesterol [(4.5+/-1.4) vs (4.2+/-1.0) mmol/L, P=0.009], triglyceride [M (Q(1), Q(3))][1.7 (1.2, 3.0) vs 1.4 (1.0, 2.3) mmol/L, P<0.001] and Cystatin C [(0.9 (0.8, 1.0) vs 0.8 (0.7, 0.9) mg/L, P<0.001] were higher in the DKD group, while high-density lipoprotein [(1.0+/-0.3) vs (1.1+/-0.3) mmol/L, P=0.001] was lower in the DKD group. Multivariate logistic regression analysis showed that the risk of DKD in the third quartile (right eye: OR=1.825, 95%CI: 1.204-2.768, P=0.005) and fourth quartile (left eye: OR=1.929, 95%CI: 1.218-3.055, P=0.005) was higher than that in the lowest quartile of vascular curvature after adjusting for age and gender. The increase of average diameter of retinal vein was associated with the risk of DKD (left eye: OR=1.044, 95%CI: 1.013-1.075, P=0.005). The decrease of vascular fractal dimension (fourth quartile of left eye: OR=0.444, 95%CI: 0.199-0.987, P=0.046) and retinal vascular density (the second and fourth quartile of the right eye: OR=0.639, 95%CI: 0.409-0.998, P=0.049; OR=0.534, 95%CI: 0.331-0.864, P=0.010) were related to the risk of DKD. Conclusions: The abnormal morphological characteristics of retinal microvessels are related to the occurrence of DKD. The increase of retinal vein diameter and the decrease of retinal vessel density correlate with the occurrence of DKD. FAU - Yang, X K AU - Yang XK AD - Department of Integrated Traditional and Western Nephrology, the First Affiliated Hospital of Zhengzhou University, Institute of Nephrology of Zhengzhou University, Henan Province Research Center For Kidney Disease, Key Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan Province, Zhengzhou 450052, China. FAU - Liu, Z S AU - Liu ZS AD - Department of Integrated Traditional and Western Nephrology, the First Affiliated Hospital of Zhengzhou University, Institute of Nephrology of Zhengzhou University, Henan Province Research Center For Kidney Disease, Key Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan Province, Zhengzhou 450052, China. FAU - Li, G P AU - Li GP AD - Department of Integrated Traditional and Western Nephrology, the First Affiliated Hospital of Zhengzhou University, Institute of Nephrology of Zhengzhou University, Henan Province Research Center For Kidney Disease, Key Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan Province, Zhengzhou 450052, China. FAU - Duan, J Y AU - Duan JY AD - Department of Integrated Traditional and Western Nephrology, the First Affiliated Hospital of Zhengzhou University, Institute of Nephrology of Zhengzhou University, Henan Province Research Center For Kidney Disease, Key Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan Province, Zhengzhou 450052, China. FAU - Liu, D W AU - Liu DW AD - Department of Integrated Traditional and Western Nephrology, the First Affiliated Hospital of Zhengzhou University, Institute of Nephrology of Zhengzhou University, Henan Province Research Center For Kidney Disease, Key Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan Province, Zhengzhou 450052, China. LA - chi GR - 82103916, 81970633/National Natural Science Foundation of China/ PT - English Abstract PT - Journal Article PL - China TA - Zhonghua Yi Xue Za Zhi JT - Zhonghua yi xue za zhi JID - 7511141 SB - IM MH - Female MH - Humans MH - Male MH - *Diabetes Mellitus, Type 2/complications MH - Retrospective Studies MH - *Diabetic Nephropathies/complications MH - Microvessels MH - Retina EDAT- 2023/05/08 00:41 MHDA- 2023/05/09 10:16 CRDT- 2023/05/07 22:00 PHST- 2023/05/09 10:16 [medline] PHST- 2023/05/08 00:41 [pubmed] PHST- 2023/05/07 22:00 [entrez] AID - 10.3760/cma.j.cn112137-20221023-02214 [doi] PST - ppublish SO - Zhonghua Yi Xue Za Zhi. 2023 May 16;103(18):1393-1400. doi: 10.3760/cma.j.cn112137-20221023-02214.