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The Adolescent Cardio-Renal Intervention Trial (AdDIT): retinal vascular geometry and renal function in adolescents with type 1 diabetes.

Publication ,  Journal Article
Benitez-Aguirre, PZ; Wong, TY; Craig, ME; Davis, EA; Cotterill, A; Couper, JJ; Cameron, FJ; Mahmud, FH; Jones, TW; Hodgson, LAB; Dalton, RN ...
Published in: Diabetologia
April 2018

AIMS/HYPOTHESIS: We examined the hypothesis that elevation in urinary albumin creatinine ratio (ACR) in adolescents with type 1 diabetes is associated with abnormal retinal vascular geometry (RVG) phenotypes. METHODS: A cross-sectional study at baseline of the relationship between ACR within the normoalbuminuric range and RVG in 963 adolescents aged 14.4 ± 1.6 years with type 1 diabetes (median duration 6.5 years) screened for participation in AdDIT. A validated algorithm was used to categorise log10 ACR into tertiles: upper tertile ACR was defined as 'high-risk' for future albuminuria and the lower two tertiles were deemed 'low-risk'. RVG analysis, using a semi-automated computer program, determined retinal vascular calibres (standard and extended zones) and tortuosity. RVG measures were analysed continuously and categorically (in quintiles: Q1-Q5) for associations with log10 ACR and ACR risk groups. RESULTS: Greater log10 ACR was associated with narrower vessel calibres and greater tortuosity. The high-risk group was more likely to have extended zone vessel calibres in the lowest quintile (arteriolar Q1 vs Q2-Q5: OR 1.67 [95% CI 1.17, 2.38] and venular OR 1.39 [0.98, 1.99]) and tortuosity in the highest quintile (Q5 vs Q1-Q4: arteriolar OR 2.05 [1.44, 2.92] and venular OR 2.38 [1.67, 3.40]). The effects of retinal vascular calibres and tortuosity were additive such that the participants with the narrowest and most tortuous vessels were more likely to be in the high-risk group (OR 3.32 [1.84, 5.96]). These effects were independent of duration, blood pressure, BMI and blood glucose control. CONCLUSIONS/INTERPRETATION: Higher ACR in adolescents is associated with narrower and more tortuous retinal vessels. Therefore, RVG phenotypes may serve to identify populations at high risk of diabetes complications during adolescence and well before onset of clinical diabetes complications.

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Published In

Diabetologia

DOI

EISSN

1432-0428

Publication Date

April 2018

Volume

61

Issue

4

Start / End Page

968 / 976

Location

Germany

Related Subject Headings

  • Risk Factors
  • Retinal Vessels
  • Retina
  • Regression Analysis
  • Prospective Studies
  • Phenotype
  • Male
  • Kidney
  • Humans
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
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Benitez-Aguirre, P. Z., Wong, T. Y., Craig, M. E., Davis, E. A., Cotterill, A., Couper, J. J., … Adolescent Type 1 Diabetes Cardio-Renal Intervention Trial (AdDIT), . (2018). The Adolescent Cardio-Renal Intervention Trial (AdDIT): retinal vascular geometry and renal function in adolescents with type 1 diabetes. Diabetologia, 61(4), 968–976. https://doi.org/10.1007/s00125-017-4538-2
Benitez-Aguirre, Paul Z., Tien Y. Wong, Maria E. Craig, Elizabeth A. Davis, Andrew Cotterill, Jennifer J. Couper, Fergus J. Cameron, et al. “The Adolescent Cardio-Renal Intervention Trial (AdDIT): retinal vascular geometry and renal function in adolescents with type 1 diabetes.Diabetologia 61, no. 4 (April 2018): 968–76. https://doi.org/10.1007/s00125-017-4538-2.
Benitez-Aguirre PZ, Wong TY, Craig ME, Davis EA, Cotterill A, Couper JJ, et al. The Adolescent Cardio-Renal Intervention Trial (AdDIT): retinal vascular geometry and renal function in adolescents with type 1 diabetes. Diabetologia. 2018 Apr;61(4):968–76.
Benitez-Aguirre, Paul Z., et al. “The Adolescent Cardio-Renal Intervention Trial (AdDIT): retinal vascular geometry and renal function in adolescents with type 1 diabetes.Diabetologia, vol. 61, no. 4, Apr. 2018, pp. 968–76. Pubmed, doi:10.1007/s00125-017-4538-2.
Benitez-Aguirre PZ, Wong TY, Craig ME, Davis EA, Cotterill A, Couper JJ, Cameron FJ, Mahmud FH, Jones TW, Hodgson LAB, Dalton RN, Dunger DB, Donaghue KC, Adolescent Type 1 Diabetes Cardio-Renal Intervention Trial (AdDIT). The Adolescent Cardio-Renal Intervention Trial (AdDIT): retinal vascular geometry and renal function in adolescents with type 1 diabetes. Diabetologia. 2018 Apr;61(4):968–976.
Journal cover image

Published In

Diabetologia

DOI

EISSN

1432-0428

Publication Date

April 2018

Volume

61

Issue

4

Start / End Page

968 / 976

Location

Germany

Related Subject Headings

  • Risk Factors
  • Retinal Vessels
  • Retina
  • Regression Analysis
  • Prospective Studies
  • Phenotype
  • Male
  • Kidney
  • Humans
  • Female