{"title":"糖尿病视网膜病变和虚弱之间的关系：来自全国健康和营养检查调查和孟德尔随机化的见解。","authors":"Jianqi Chen, Xuhao Chen, Xu Cao, Xiaohua Zhuo, Yuwen Wen, Guitong Ye, Yuan Zhang, Jinan Zhan, Hongmei Tan, Yingting Zhu, Yehong Zhuo","doi":"10.1167/tvst.14.2.2","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To elucidate the relationship between diabetic retinopathy (DR) and frailty and investigate genetic correlations and causality.</p><p><strong>Methods: </strong>We analyzed data from the US National Health and Nutrition Examination Survey, which included 1003 individuals with diabetes. DR was evaluated via nonmydriatic retinal imaging, and frailty was measured using a 49-item frailty index. The association between DR and frailty was assessed using survey-weighted logistics regression adjusted for multiple covariates, including age, sex, race, education level, family income-to-poverty ratio, marital status, and Healthy Eating Index. Genetic correlations and causal relationships were investigated through linkage disequilibrium score regression and bidirectional Mendelian randomization.</p><p><strong>Results: </strong>DR was significantly associated with higher odds of frailty after full adjustment (odd ratio [OR] = 4.25; 95% confidence interval [CI], 1.08-16.67; P = 0.040). The association was robust and did not significantly differ across age (P interaction = 0.080), sex (P interaction = 0.216), or race (P interaction = 0.749) groups. DR exhibited a moderate but significant genetic correlation with frailty (rg = 0.27, standard error = 0.04; P = 2.43 × 10-10). Genetically inferred DR was significantly associated with a greater frailty index (β = 0.03; 95% CI, 0.01-0.05; P < 0.001), whereas frailty was not associated with DR risk (OR = 1.20; 95% CI, 0.80-1.81; P = 0.376).</p><p><strong>Conclusions: </strong>Our findings suggest that DR is associated with an increased risk of frailty, indicating that DR not only impairs vision but also accelerates physical decline.</p><p><strong>Translational relevance: </strong>This study highlights the critical need for integrated care approaches that incorporate frailty screening and proactive management in individuals with DR to prevent further health deterioration and improve both quality of life and long-term outcomes.</p>","PeriodicalId":23322,"journal":{"name":"Translational Vision Science & Technology","volume":"14 2","pages":"2"},"PeriodicalIF":2.6000,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11798332/pdf/","citationCount":"0","resultStr":"{\"title\":\"Associations Between Diabetic Retinopathy and Frailty: Insights From the National Health and Nutrition Examination Survey and Mendelian Randomization.\",\"authors\":\"Jianqi Chen, Xuhao Chen, Xu Cao, Xiaohua Zhuo, Yuwen Wen, Guitong Ye, Yuan Zhang, Jinan Zhan, Hongmei Tan, Yingting Zhu, Yehong Zhuo\",\"doi\":\"10.1167/tvst.14.2.2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To elucidate the relationship between diabetic retinopathy (DR) and frailty and investigate genetic correlations and causality.</p><p><strong>Methods: </strong>We analyzed data from the US National Health and Nutrition Examination Survey, which included 1003 individuals with diabetes. DR was evaluated via nonmydriatic retinal imaging, and frailty was measured using a 49-item frailty index. The association between DR and frailty was assessed using survey-weighted logistics regression adjusted for multiple covariates, including age, sex, race, education level, family income-to-poverty ratio, marital status, and Healthy Eating Index. Genetic correlations and causal relationships were investigated through linkage disequilibrium score regression and bidirectional Mendelian randomization.</p><p><strong>Results: </strong>DR was significantly associated with higher odds of frailty after full adjustment (odd ratio [OR] = 4.25; 95% confidence interval [CI], 1.08-16.67; P = 0.040). The association was robust and did not significantly differ across age (P interaction = 0.080), sex (P interaction = 0.216), or race (P interaction = 0.749) groups. DR exhibited a moderate but significant genetic correlation with frailty (rg = 0.27, standard error = 0.04; P = 2.43 × 10-10). Genetically inferred DR was significantly associated with a greater frailty index (β = 0.03; 95% CI, 0.01-0.05; P < 0.001), whereas frailty was not associated with DR risk (OR = 1.20; 95% CI, 0.80-1.81; P = 0.376).</p><p><strong>Conclusions: </strong>Our findings suggest that DR is associated with an increased risk of frailty, indicating that DR not only impairs vision but also accelerates physical decline.</p><p><strong>Translational relevance: </strong>This study highlights the critical need for integrated care approaches that incorporate frailty screening and proactive management in individuals with DR to prevent further health deterioration and improve both quality of life and long-term outcomes.</p>\",\"PeriodicalId\":23322,\"journal\":{\"name\":\"Translational Vision Science & Technology\",\"volume\":\"14 2\",\"pages\":\"2\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-02-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11798332/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Translational Vision Science & Technology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1167/tvst.14.2.2\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Translational Vision Science & Technology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1167/tvst.14.2.2","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
Associations Between Diabetic Retinopathy and Frailty: Insights From the National Health and Nutrition Examination Survey and Mendelian Randomization.
Purpose: To elucidate the relationship between diabetic retinopathy (DR) and frailty and investigate genetic correlations and causality.
Methods: We analyzed data from the US National Health and Nutrition Examination Survey, which included 1003 individuals with diabetes. DR was evaluated via nonmydriatic retinal imaging, and frailty was measured using a 49-item frailty index. The association between DR and frailty was assessed using survey-weighted logistics regression adjusted for multiple covariates, including age, sex, race, education level, family income-to-poverty ratio, marital status, and Healthy Eating Index. Genetic correlations and causal relationships were investigated through linkage disequilibrium score regression and bidirectional Mendelian randomization.
Results: DR was significantly associated with higher odds of frailty after full adjustment (odd ratio [OR] = 4.25; 95% confidence interval [CI], 1.08-16.67; P = 0.040). The association was robust and did not significantly differ across age (P interaction = 0.080), sex (P interaction = 0.216), or race (P interaction = 0.749) groups. DR exhibited a moderate but significant genetic correlation with frailty (rg = 0.27, standard error = 0.04; P = 2.43 × 10-10). Genetically inferred DR was significantly associated with a greater frailty index (β = 0.03; 95% CI, 0.01-0.05; P < 0.001), whereas frailty was not associated with DR risk (OR = 1.20; 95% CI, 0.80-1.81; P = 0.376).
Conclusions: Our findings suggest that DR is associated with an increased risk of frailty, indicating that DR not only impairs vision but also accelerates physical decline.
Translational relevance: This study highlights the critical need for integrated care approaches that incorporate frailty screening and proactive management in individuals with DR to prevent further health deterioration and improve both quality of life and long-term outcomes.
期刊介绍：
Translational Vision Science & Technology (TVST), an official journal of the Association for Research in Vision and Ophthalmology (ARVO), an international organization whose purpose is to advance research worldwide into understanding the visual system and preventing, treating and curing its disorders, is an online, open access, peer-reviewed journal emphasizing multidisciplinary research that bridges the gap between basic research and clinical care. A highly qualified and diverse group of Associate Editors and Editorial Board Members is led by Editor-in-Chief Marco Zarbin, MD, PhD, FARVO.
The journal covers a broad spectrum of work, including but not limited to:
Applications of stem cell technology for regenerative medicine,
Development of new animal models of human diseases,
Tissue bioengineering,
Chemical engineering to improve virus-based gene delivery,
Nanotechnology for drug delivery,
Design and synthesis of artificial extracellular matrices,
Development of a true microsurgical operating environment,
Refining data analysis algorithms to improve in vivo imaging technology,
Results of Phase 1 clinical trials,
Reverse translational ("bedside to bench") research.
TVST seeks manuscripts from scientists and clinicians with diverse backgrounds ranging from basic chemistry to ophthalmic surgery that will advance or change the way we understand and/or treat vision-threatening diseases. TVST encourages the use of color, multimedia, hyperlinks, program code and other digital enhancements.
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