Glycemic Thresholds for Diabetes-Specific Retinopathy: Implications for diagnostic criteria for diabetes
Identifieur interne : 006A69 ( Main/Exploration ); précédent : 006A68; suivant : 006A70Glycemic Thresholds for Diabetes-Specific Retinopathy: Implications for diagnostic criteria for diabetes
Auteurs : Stephen Colagiuri [Australie] ; Crystal M. Y. Lee [Australie] ; Tien Y. Wong [Australie, Singapour] ; Beverley Balkau [France] ; Jonathan E. Shaw [Australie] ; Knut Borch-Johnsen [Danemark]Source :
- Diabetes care [ 0149-5992 ] ; 2011.
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- Pascal (Inist)
- Wicri :
English descriptors
- KwdEn :
Abstract
OBJECTIVE - To re-evaluate the relationship between glycemia and diabetic retinopathy. RESEARCH DESIGN AND METHODS - We conducted a data-pooling analysis of nine studies from five countries with 44,623 participants aged 20-79 years with gradable retinal photographs. The relationship between diabetes-specific retinopathy (defined as moderate or more severe retinopathy) and three glycemic measures (fasting plasma glucose [FPG; n = 41,411], 2-h post oral glucose load plasma glucose [2-h PG; n = 21,334], and AlC [n = 28,010]) was examined. RESULTS- When diabetes-specific retinopathy was plotted against continuous glycemic measures, a curvilinear relationship was observed for FPG and AlC. Diabetes-specific retinopathy prevalence was low for FPG <6.0 mmol/l and AlC <6.0% but increased above these levels. Based on vigintile (20 groups with equal numbers) distributions, glycemic thresholds for diabetes-specific retinopathy were observed over the range of 6.4-6.8 mmol/l for FPG, 9.8-10.6 mmol/l for 2-h PG, and 6.3-6.7% for AlC. Thresholds for diabetes-specific retinopathy from receiver-operating characteristic curve analyses were 6.6 mmol/l for FPG, 13.0 mmol/l for 2-h PG, and 6.4% for AlC. CONCLUSIONS - This study broadens the evidence based on diabetes diagnostic criteria. A narrow threshold range for diabetes-specific retinopathy was identified for FPG and AlC but not for 2-h PG. The combined analyses suggest that the current diabetes diagnostic level for FPG could be lowered to 6.5 mmol/l and that an AlC of 6.5% is a suitable alternative diagnostic criterion.
Affiliations:
- Australie, Danemark, France, Singapour
- Nouvelle-Galles du Sud, Victoria (État), Île-de-France
- Melbourne, Orsay, Sydney
- Université Paris-Sud, Université de Melbourne, Université de Sydney, Université nationale de Singapour
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Glycemic Thresholds for Diabetes-Specific Retinopathy: Implications for diagnostic criteria for diabetes</title>
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<author><name sortKey="Borch Johnsen, Knut" sort="Borch Johnsen, Knut" uniqKey="Borch Johnsen K" first="Knut" last="Borch-Johnsen">Knut Borch-Johnsen</name>
<affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Steno Diabetes Center</s1>
<s2>Gentofte</s2>
<s3>DNK</s3>
<sZ>6 aut.</sZ>
</inist:fA14>
<country>Danemark</country>
<wicri:noRegion>Steno Diabetes Center</wicri:noRegion>
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<series><title level="j" type="main">Diabetes care</title>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Criterion</term>
<term>Diabetes mellitus</term>
<term>Diagnosis</term>
<term>Endocrinology</term>
<term>Glycemia</term>
<term>Human</term>
<term>Metabolic diseases</term>
<term>Nutrition</term>
<term>Retinopathy</term>
<term>Threshold</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Diabète</term>
<term>Glycémie</term>
<term>Seuil</term>
<term>Rétinopathie</term>
<term>Diagnostic</term>
<term>Critère</term>
<term>Endocrinologie</term>
<term>Maladie métabolique</term>
<term>Nutrition</term>
<term>Homme</term>
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<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Diabète</term>
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<front><div type="abstract" xml:lang="en">OBJECTIVE - To re-evaluate the relationship between glycemia and diabetic retinopathy. RESEARCH DESIGN AND METHODS - We conducted a data-pooling analysis of nine studies from five countries with 44,623 participants aged 20-79 years with gradable retinal photographs. The relationship between diabetes-specific retinopathy (defined as moderate or more severe retinopathy) and three glycemic measures (fasting plasma glucose [FPG; n = 41,411], 2-h post oral glucose load plasma glucose [2-h PG; n = 21,334], and AlC [n = 28,010]) was examined. RESULTS- When diabetes-specific retinopathy was plotted against continuous glycemic measures, a curvilinear relationship was observed for FPG and AlC. Diabetes-specific retinopathy prevalence was low for FPG <6.0 mmol/l and AlC <6.0% but increased above these levels. Based on vigintile (20 groups with equal numbers) distributions, glycemic thresholds for diabetes-specific retinopathy were observed over the range of 6.4-6.8 mmol/l for FPG, 9.8-10.6 mmol/l for 2-h PG, and 6.3-6.7% for AlC. Thresholds for diabetes-specific retinopathy from receiver-operating characteristic curve analyses were 6.6 mmol/l for FPG, 13.0 mmol/l for 2-h PG, and 6.4% for AlC. CONCLUSIONS - This study broadens the evidence based on diabetes diagnostic criteria. A narrow threshold range for diabetes-specific retinopathy was identified for FPG and AlC but not for 2-h PG. The combined analyses suggest that the current diabetes diagnostic level for FPG could be lowered to 6.5 mmol/l and that an AlC of 6.5% is a suitable alternative diagnostic criterion.</div>
</front>
</TEI>
<affiliations><list><country><li>Australie</li>
<li>Danemark</li>
<li>France</li>
<li>Singapour</li>
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<li>Victoria (État)</li>
<li>Île-de-France</li>
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<li>Orsay</li>
<li>Sydney</li>
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<orgName><li>Université Paris-Sud</li>
<li>Université de Melbourne</li>
<li>Université de Sydney</li>
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<tree><country name="Australie"><region name="Nouvelle-Galles du Sud"><name sortKey="Colagiuri, Stephen" sort="Colagiuri, Stephen" uniqKey="Colagiuri S" first="Stephen" last="Colagiuri">Stephen Colagiuri</name>
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<name sortKey="Lee, Crystal M Y" sort="Lee, Crystal M Y" uniqKey="Lee C" first="Crystal M. Y." last="Lee">Crystal M. Y. Lee</name>
<name sortKey="Shaw, Jonathan E" sort="Shaw, Jonathan E" uniqKey="Shaw J" first="Jonathan E." last="Shaw">Jonathan E. Shaw</name>
<name sortKey="Wong, Tien Y" sort="Wong, Tien Y" uniqKey="Wong T" first="Tien Y." last="Wong">Tien Y. Wong</name>
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<country name="France"><noRegion><name sortKey="Balkau, Beverley" sort="Balkau, Beverley" uniqKey="Balkau B" first="Beverley" last="Balkau">Beverley Balkau</name>
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<country name="Danemark"><noRegion><name sortKey="Borch Johnsen, Knut" sort="Borch Johnsen, Knut" uniqKey="Borch Johnsen K" first="Knut" last="Borch-Johnsen">Knut Borch-Johnsen</name>
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<name sortKey="Borch Johnsen, Knut" sort="Borch Johnsen, Knut" uniqKey="Borch Johnsen K" first="Knut" last="Borch-Johnsen">Knut Borch-Johnsen</name>
</country>
</tree>
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