Maraschin Clara Krummenauer, Alessi Janine, Reis Mateus Augusto Dos, Molino Gabriela Oliveira Gonçalves, Teló Gabriela Heiden, Schaan Beatriz D
Universidade Federal do Rio Grande do Sul Porto Alegre RS Brasil Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil.
Universidade Católica do Rio Grande do Sul Faculdade de Medicina Porto Alegre RS Brasil Faculdade de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brasil.
Arch Endocrinol Metab. 2025 May 9;69(2):e240258. doi: 10.20945/2359-4292-2024-0258.
To evaluate the association between diabetic retinopathy, diabetic kidney disease, and the 10-year risk of atherosclerotic cardiovascular disease in patients with diabetes.
A cross-sectional study was performed involving patients diagnosed with either type 1 or type 2 diabetes mellitus. Participants were classified into four groups: DM (patients without diabetes-related complications), DR (patients with diabetic retinopathy only), DKD (patients with diabetic kidney disease only), and DR + DKD (patients with both diabetic retinopathy and diabetic kidney disease). The primary outcome was the 10-year risk assessment for cardiovascular events, calculated using the American Heart Association's atherosclerotic cardiovascular disease score.
A total of 571 patients were selected including 128 with type 1 diabetes (average age of 39.4 ± 15.1 years; 48.4% female) and 443 with type 2 diabetes (average age of 59.5 ± 11.9 years; 66.4% female). Among the participants with type 2 diabetes, the cardiovascular risk was 15.2 ± 14.6% for the DM group, 15.7 ± 10.7% for the DR group, 22.5 ± 16.7% for the DKD group, and 21.5 ± 15.1% for the DR + DKD group, reflecting a significantly higher cardiovascular risk in the groups with renal involvement (P <0.001). For those with type 1 diabetes, the DM group had a risk of 6.1 ± 8.9%, the DR group 8.9 ±11.8%, the DKD group 5.4 ± 8.8%, and the DR + DKD group 6.1 ± 9.5%. The mean difference in risk between the groups was not statistically significant.
In patients with type 2 diabetes, those with diabetic kidney disease appeared to have a higher theoretical risk of cardiovascular disease compared to those with only diabetic retinopathy.
评估糖尿病患者糖尿病视网膜病变、糖尿病肾病与动脉粥样硬化性心血管疾病10年风险之间的关联。
进行了一项横断面研究，纳入诊断为1型或2型糖尿病的患者。参与者分为四组：糖尿病组（无糖尿病相关并发症的患者）、糖尿病视网膜病变组（仅患有糖尿病视网膜病变的患者）、糖尿病肾病组（仅患有糖尿病肾病的患者）和糖尿病视网膜病变 + 糖尿病肾病组（同时患有糖尿病视网膜病变和糖尿病肾病的患者）。主要结局是使用美国心脏协会的动脉粥样硬化性心血管疾病评分计算的心血管事件10年风险评估。
共选取571例患者，其中128例为1型糖尿病患者（平均年龄39.4±15.1岁；48.4%为女性），443例为2型糖尿病患者（平均年龄59.5±11.9岁；66.4%为女性）。在2型糖尿病参与者中，糖尿病组的心血管风险为15.2±14.6%，糖尿病视网膜病变组为15.7±10.7%，糖尿病肾病组为22.5±16.7%，糖尿病视网膜病变 + 糖尿病肾病组为21.5±15.1%，这表明肾脏受累组的心血管风险显著更高（P<0.001）。对于1型糖尿病患者，糖尿病组的风险为6.1±8.9%，糖尿病视网膜病变组为8.9±11.8%，糖尿病肾病组为5.4±8.8%，糖尿病视网膜病变 + 糖尿病肾病组为6.1±9.5%。各组之间的风险平均差异无统计学意义。
在2型糖尿病患者中，与仅患有糖尿病视网膜病变的患者相比，患有糖尿病肾病的患者似乎具有更高的心血管疾病理论风险。
