Prevalence and Relationship Between Diabetic Retinopathy and Nephropathy, and its Risk Factors in the North-East of Spain, a Population-Based Study

Abstract

Purpose: To determine the prevalence of microangiopathy, and its risk factors in a population-based study of diabetes mellitus patients in the north-eastern area of Spain.

Methods: A population-based transversal study of 8,187 type 2 (83.37% of the diagnosed patients) and 488 type 1 (85.76% of the diagnosed patients) underwent a detailed medical history that included: diagnoses of diabetic retinopathy, macular edema, microalbuminuria or overt nephropathy. A study of its risk factors, and the relationship between diabetic retinopathy and renal lesion was performed.

Results: In type 1 diabetes patients we observed a prevalence of 36.47% of diabetic retinopathy and 5.73% with macular edema; in type 2 diabetes patients the prevalence of diabetic retinopathy was 26.11% and 6.44% with macular edema. Microalbuminuria prevalence was 25.61% in type 1 and 17.78% in type 2 patients, and overt nephropathy prevalence was 8.60% in type 1 and 6.74% in type 2 diabetic patients. The risk factors for diabetic retinopathy were: diabetes duration, high glycosylated level, and arterial hypertension, and insulin treatment in type 2. The Total-cholesterol/High Density-cholesterol (TC/HDL) ratio and triglycerides were significant for diabetic macular edema (DME). Microalbuminuria and overt nephropathy were well correlated to diabetes duration, arterial hypertension and glycosylated haemoglobin.

Conclusions: Prevalence and risk factors for microangiopathy are similar to other studies, and the important finding is that the TC/HDL ratio was significant for DME. Microalbuminuria is a risk factor for diabetic retinopathy in type 1 diabetes mellitus patients but not for type 2. Overt nephropathy is well correlated with diabetic retinopathy.

KEYWORDS::

• Diabetic retinopathy
• Diabetic macular edema
• Microalbuminuria
• Overt nephropathy
• Prevalence
• Epidemiological study
• TC/HDL ratio

ACKNOWLEDGMENTS

To all the Family Physicians in our area who helped us to implement the new screening system using the nonmydriatic fundus camera and to our camera technicians for their work and interest in the new method.

The local scientific investigative ethical committee also gave us their agreement, according Helsinki declaration. All patients of second group signed an informed consent to be given into the study

Declaration of Interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.