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.
Descripteurs français
- 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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Wong</name><affiliation wicri:level="4"><inist:fA14 i1="02"><s1>Center for Eye Research Australia, University of Melbourne</s1><s2>Melbourne</s2><s3>AUS</s3><sZ>3 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region><settlement type="city">Melbourne</settlement></placeName><orgName type="university">Université de Melbourne</orgName></affiliation><affiliation wicri:level="4"><inist:fA14 i1="03"><s1>Singapore Eye Research Institute, National University of Singapore</s1><s3>SGP</s3><sZ>3 aut.</sZ></inist:fA14><country>Singapour</country><orgName type="university">Université nationale de Singapour</orgName></affiliation></author><author><name sortKey="Balkau, Beverley" sort="Balkau, Beverley" uniqKey="Balkau B" first="Beverley" last="Balkau">Beverley Balkau</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Institut National de la Santé et de la Recherche Médicale, Centre de Recherche en Epidémiologie et Santé des Populations, Epidemiology of Diabetes, Obesity, and Chronic Kidney Disease Over the Lifecourse</s1><s2>Villejuif</s2><s3>FRA</s3><sZ>4 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Villejuif</wicri:noRegion><wicri:noRegion>and Chronic Kidney Disease Over the Lifecourse</wicri:noRegion><wicri:noRegion>Villejuif</wicri:noRegion></affiliation><affiliation wicri:level="4"><inist:fA14 i1="05"><s1>Centre de Recherche en Epidémiologie et Santé des Populations, Université Paris Sud</s1><s2>Villejuif</s2><s3>FRA</s3><sZ>4 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Villejuif</wicri:noRegion><wicri:noRegion>Université Paris Sud</wicri:noRegion><placeName><settlement type="city">Orsay</settlement><region type="region" nuts="2">Île-de-France</region></placeName><orgName type="university">Université Paris-Sud</orgName></affiliation></author><author><name sortKey="Shaw, Jonathan E" sort="Shaw, Jonathan E" uniqKey="Shaw J" first="Jonathan E." last="Shaw">Jonathan E. 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Y." last="Lee">Crystal M. Y. Lee</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Boden Institute of Obesity, Nutrition, and Exercise, University of Sydney</s1><s2>Sydney</s2><s3>AUS</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region><settlement type="city">Sydney</settlement></placeName><orgName type="university">Université de Sydney</orgName></affiliation></author><author><name sortKey="Wong, Tien Y" sort="Wong, Tien Y" uniqKey="Wong T" first="Tien Y." last="Wong">Tien Y. Wong</name><affiliation wicri:level="4"><inist:fA14 i1="02"><s1>Center for Eye Research Australia, University of Melbourne</s1><s2>Melbourne</s2><s3>AUS</s3><sZ>3 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region><settlement type="city">Melbourne</settlement></placeName><orgName type="university">Université de Melbourne</orgName></affiliation><affiliation wicri:level="4"><inist:fA14 i1="03"><s1>Singapore Eye Research Institute, National University of Singapore</s1><s3>SGP</s3><sZ>3 aut.</sZ></inist:fA14><country>Singapour</country><orgName type="university">Université nationale de Singapour</orgName></affiliation></author><author><name sortKey="Balkau, Beverley" sort="Balkau, Beverley" uniqKey="Balkau B" first="Beverley" last="Balkau">Beverley Balkau</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Institut National de la Santé et de la Recherche Médicale, Centre de Recherche en Epidémiologie et Santé des Populations, Epidemiology of Diabetes, Obesity, and Chronic Kidney Disease Over the Lifecourse</s1><s2>Villejuif</s2><s3>FRA</s3><sZ>4 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Villejuif</wicri:noRegion><wicri:noRegion>and Chronic Kidney Disease Over the Lifecourse</wicri:noRegion><wicri:noRegion>Villejuif</wicri:noRegion></affiliation><affiliation wicri:level="4"><inist:fA14 i1="05"><s1>Centre de Recherche en Epidémiologie et Santé des Populations, Université Paris Sud</s1><s2>Villejuif</s2><s3>FRA</s3><sZ>4 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Villejuif</wicri:noRegion><wicri:noRegion>Université Paris Sud</wicri:noRegion><placeName><settlement type="city">Orsay</settlement><region type="region" nuts="2">Île-de-France</region></placeName><orgName type="university">Université Paris-Sud</orgName></affiliation></author><author><name sortKey="Shaw, Jonathan E" sort="Shaw, Jonathan E" uniqKey="Shaw J" first="Jonathan E." last="Shaw">Jonathan E. Shaw</name><affiliation wicri:level="3"><inist:fA14 i1="06"><s1>Heart and Diabetes Institute, Baker International Diabetes Institute</s1><s2>Melbourne</s2><s3>AUS</s3><sZ>5 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><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></affiliation><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Faculty of Health Science, University of Aarhus</s1><s2>Aarhus</s2><s3>DNK</s3><sZ>6 aut.</sZ></inist:fA14><country>Danemark</country><wicri:noRegion>Aarhus</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Diabetes care</title><title level="j" type="abbreviated">Diabetes care</title><idno type="ISSN">0149-5992</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Diabetes care</title><title level="j" type="abbreviated">Diabetes care</title><idno type="ISSN">0149-5992</idno></seriesStmt></fileDesc><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></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Diabète</term><term>Nutrition</term><term>Homme</term></keywords></textClass></profileDesc></teiHeader><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></country><region><li>Nouvelle-Galles du Sud</li><li>Victoria (État)</li><li>Île-de-France</li></region><settlement><li>Melbourne</li><li>Orsay</li><li>Sydney</li></settlement><orgName><li>Université Paris-Sud</li><li>Université de Melbourne</li><li>Université de Sydney</li><li>Université nationale de Singapour</li></orgName></list><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></region><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></country><country name="Singapour"><noRegion><name sortKey="Wong, Tien Y" sort="Wong, Tien Y" uniqKey="Wong T" first="Tien Y." last="Wong">Tien Y. Wong</name></noRegion></country><country name="France"><noRegion><name sortKey="Balkau, Beverley" sort="Balkau, Beverley" uniqKey="Balkau B" first="Beverley" last="Balkau">Beverley Balkau</name></noRegion><name sortKey="Balkau, Beverley" sort="Balkau, Beverley" uniqKey="Balkau B" first="Beverley" last="Balkau">Beverley Balkau</name></country><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></noRegion><name sortKey="Borch Johnsen, Knut" sort="Borch Johnsen, Knut" uniqKey="Borch Johnsen K" first="Knut" last="Borch-Johnsen">Knut Borch-Johnsen</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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