TY - JOUR
T1 - Diabetic retinopathy is a predictor of chronic respiratory failure
T2 - A nationwide register-based cohort study
AU - Thinggaard, Benjamin Sommer
AU - Stokholm, Lonny
AU - Davidsen, Jesper Rømhild
AU - Larsen, Maria Carius
AU - Möller, Sören
AU - Thykjær, Anne Suhr
AU - Andresen, Jens Lundgaard
AU - Andersen, Nis
AU - Heegaard, Steffen
AU - Højlund, Kurt
AU - Kawasaki, Ryo
AU - Laugesen, Caroline
AU - Bek, Toke
AU - Grauslund, Jakob
N1 - Publisher Copyright:
© 2023
PY - 2023/6
Y1 - 2023/6
N2 - PURPOSE: Diabetic retinopathy (DR) is a hypoxic retinal disease, but so far, the association with systemic hypoxia is poorly understood. Hence, the aim of this study was to evaluate cross-sectional and longitudinal associations between DR and chronic respiratory failure (CRF) in a national cohort.DESIGN: Cross-sectional and 5-year longitudinal register-based cohort study.METHODS: Between 2013 and 2018, we included patients with diabetes from the Danish Registry of Diabetic Retinopathy, who were each age and sex matched with five controls without diabetes. At index date, the prevalence of CRF was compared between cases and controls, and the longitudinal relationship between DR and CRF was assessed in a five-year follow-up.RESULTS: At baseline, we identified 1,980 and 9,990 patients with CRF among 205,970 cases and 1,003,170 controls. The prevalence of CRF was higher among cases than controls (OR 1.75, 95% CI 1.65-1.86), but no difference between cases with and without DR was found.During follow-up, we identified 1,726 and 5,177 events of CRF among cases and controls, respectively. The incidence of CRF was higher among both cases with and without DR compared to controls (DR level 0: HR 1.24, 95% CI 1.16-1.33, DR level 1-4: HR 1.86, 95% CI 1.63-2.12), and higher among cases with DR compared to cases without DR (HR 1.54, 95% CI 1.38-1.72).CONCLUSION: In this study based on nationwide data, we found an increased risk of present and incident CRF in patients with diabetes with or without DR, and we identified DR as a predictor of future CRF.
AB - PURPOSE: Diabetic retinopathy (DR) is a hypoxic retinal disease, but so far, the association with systemic hypoxia is poorly understood. Hence, the aim of this study was to evaluate cross-sectional and longitudinal associations between DR and chronic respiratory failure (CRF) in a national cohort.DESIGN: Cross-sectional and 5-year longitudinal register-based cohort study.METHODS: Between 2013 and 2018, we included patients with diabetes from the Danish Registry of Diabetic Retinopathy, who were each age and sex matched with five controls without diabetes. At index date, the prevalence of CRF was compared between cases and controls, and the longitudinal relationship between DR and CRF was assessed in a five-year follow-up.RESULTS: At baseline, we identified 1,980 and 9,990 patients with CRF among 205,970 cases and 1,003,170 controls. The prevalence of CRF was higher among cases than controls (OR 1.75, 95% CI 1.65-1.86), but no difference between cases with and without DR was found.During follow-up, we identified 1,726 and 5,177 events of CRF among cases and controls, respectively. The incidence of CRF was higher among both cases with and without DR compared to controls (DR level 0: HR 1.24, 95% CI 1.16-1.33, DR level 1-4: HR 1.86, 95% CI 1.63-2.12), and higher among cases with DR compared to cases without DR (HR 1.54, 95% CI 1.38-1.72).CONCLUSION: In this study based on nationwide data, we found an increased risk of present and incident CRF in patients with diabetes with or without DR, and we identified DR as a predictor of future CRF.
KW - Chronic respiratory failure
KW - Diabetes mellitus
KW - Diabetic retinopathy
KW - Epidemiology
KW - Screening for diabetic retinopathy
KW - Systemic hypoxia
U2 - 10.1016/j.heliyon.2023.e17342
DO - 10.1016/j.heliyon.2023.e17342
M3 - Journal article
C2 - 37426795
SN - 2405-8440
VL - 9
JO - Heliyon
JF - Heliyon
IS - 6
M1 - e17342
ER -