The Prevalance of Retinopathy and Nephropathy in Prediabetic Population
Project no. 20250 · Status: Kapanmış (Yayın bekleniyor) · 2019
Summary
Aim and purpose: Prediabetes is a condition which plasma glucose levels are higher than normal but do not reach the level of diabetes diagnose standards. Previous observational studies have shown that prediabetes is associated with increased cardiovascular risk, mortality and development of diabetes. In some studies, it has been shown that the frequency of microvascular complications is increased in prediabetic individuals. Diabetic retinopathy is one of the most important preventable causes of blindness in the world and the most common treatable microvascular chronic complication of diabetes.Diabetic nephropathy is the leading cause of CRF worldwide. Diagnosis and treatment of microvascular complications of diabetes in the prediabetes stage is expected to prevent future complications such as CRF and blindness. Therefore, it will be important to know the incidence of retinopathy and nephropathy in the prediabetic population. A study on this issue in Turkey is not yet available in the literature. Material and method: We selected, 30 IFG, 30 IGT and 30 IFG+IGT prediabetic patients, who admitted to Ege University Medicine Faculty between January 2019 – September 2019 and who has the results of OGTT and serum creatinin levels in the database of Department of Biochemistry. The information of age, gender, smoking status and presence of prediabetes risk factors (known hypertension, hyperlipidemia, psychiatric disease, gestational diabetes or history of giving birth to a large baby, history of coronary, peripheral or cerebral vascular disease and family history of diabetes mellitus) were obtained from patients. Height, body weight and waist circumference were measured. Microalbumin/creatinine ratio in spot urine was examined in the first urine sample taken in the morning. Detailed eye examination performed in Ege University Faculty of Medicine Department of Ophthalmology and fundus fluorescein angiography (FFA) was performed in 86 eligible patients. Results: Of the 86 patients included in our study, 16 (18.6%) had very mild non-proliferative retinopathy according to FFA findings. Nephropathy was detected in 13 of 86 patients (15.1%). There were 25 patients (29.1%) with retinopathy or nephropathy. The distribution of retinopathy according to prediabetes subtypes was found to be 14.3% in the IFG group, 13.8% in the IGT group, and 27.6% in the IFG+IGT group. The rate of nephropathy was 10.7% in the IFG group, 13.8% in the IGT group, and 20.7% in the IFG+IGT group. Total complication rate was found to be 21.4% in IFG group, 27.6% in IGT group and 37.9% in IFG+IGT group. These differences between the groups were not statistically significant. In our study, diabetic retinopathy was found to be significantly associated with age, systolic and diastolic blood pressure, serum uric acid level, e-GFR and anti-hyperlipidemic drug use. A significant relationship was found between diabetic nephropathy and systolic blood pressure, serum uric acid level and e-GFR level. There was a significant relationship between the presence of known vascular (coronary, serebral or peripheral) disease and both retinopathy and nephropathy. Conclusion: In our study, both the incidence of retinopathy and nephropathy may be higher than expected in prediabetic patients (%18,6 vs %15,1). High complication rates have been shown in all prediabetes subtypes, most commonly in the combined disorder (IFG + IGT) group. In addition, it has been described that there may be a relationship between macrovascular complications and microvascular complications in prediabetic patients. In the light of recent studies, it is seen that not only macrovascular complications but also microvascular complications are higher in prediabetic patients compared to the previous known rates. Therefore, as studies on this subject increase, there is a possibility that approaches about screening and treatment will change.