Yeon Soo Park , Kyu Na Lee , Bo Kyung Koo , Soo Heon Kwak , Kyung Do Han , Min Kyong Moon
{"title":"糖尿病视网膜病变和慢性肾脏疾病协同增加2型糖尿病心血管疾病发生的风险:来自两项队列研究的见解","authors":"Yeon Soo Park , Kyu Na Lee , Bo Kyung Koo , Soo Heon Kwak , Kyung Do Han , Min Kyong Moon","doi":"10.1016/j.diabres.2025.112373","DOIUrl":null,"url":null,"abstract":"<div><h3>Aims</h3><div>Chronic kidney disease (CKD) is a well-established cardiovascular risk factor for type 2 diabetes (T2D); however, the role of diabetic retinopathy (DR) remains unclear. This study evaluated the individual and combined effects of DR and CKD on cardiovascular disease (CVD) in T2D.</div></div><div><h3>Methods</h3><div>We analyzed individuals with T2D and no prior CVD from the Korean NHIS cohort (n = 2,064,406) and the UK Biobank (n = 21,350). The primary outcome was a composite of cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke.</div></div><div><h3>Results</h3><div>In the Korean cohort, adjusted hazard ratios (aHRs) for the primary outcome were elevated in those with PDR (aHR 1.37), CKD (aHR 1.36), and even more so when both were present (aHR 2.21), compared to individuals without DR or CKD. Similar results were observed in the UK Biobank. The effect of PDR on CVD was strongest in younger individuals, with aHRs of 3.28 (<40 years), 1.77 (40–64 years), and 1.29 (≥65 years) (Reference: No DR in each age group).</div></div><div><h3>Conclusions</h3><div>PDR and CKD, both independently and in combination, increase cardiovascular risk in individuals with T2D, particularly among younger age groups. These findings support incorporating PDR into cardiovascular risk assessment and management.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"226 ","pages":"Article 112373"},"PeriodicalIF":6.1000,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Diabetic retinopathy and chronic kidney disease synergistically increase the risk of incident cardiovascular disease in type 2 diabetes: Insights from two cohort studies\",\"authors\":\"Yeon Soo Park , Kyu Na Lee , Bo Kyung Koo , Soo Heon Kwak , Kyung Do Han , Min Kyong Moon\",\"doi\":\"10.1016/j.diabres.2025.112373\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Aims</h3><div>Chronic kidney disease (CKD) is a well-established cardiovascular risk factor for type 2 diabetes (T2D); however, the role of diabetic retinopathy (DR) remains unclear. This study evaluated the individual and combined effects of DR and CKD on cardiovascular disease (CVD) in T2D.</div></div><div><h3>Methods</h3><div>We analyzed individuals with T2D and no prior CVD from the Korean NHIS cohort (n = 2,064,406) and the UK Biobank (n = 21,350). The primary outcome was a composite of cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke.</div></div><div><h3>Results</h3><div>In the Korean cohort, adjusted hazard ratios (aHRs) for the primary outcome were elevated in those with PDR (aHR 1.37), CKD (aHR 1.36), and even more so when both were present (aHR 2.21), compared to individuals without DR or CKD. Similar results were observed in the UK Biobank. The effect of PDR on CVD was strongest in younger individuals, with aHRs of 3.28 (<40 years), 1.77 (40–64 years), and 1.29 (≥65 years) (Reference: No DR in each age group).</div></div><div><h3>Conclusions</h3><div>PDR and CKD, both independently and in combination, increase cardiovascular risk in individuals with T2D, particularly among younger age groups. These findings support incorporating PDR into cardiovascular risk assessment and management.</div></div>\",\"PeriodicalId\":11249,\"journal\":{\"name\":\"Diabetes research and clinical practice\",\"volume\":\"226 \",\"pages\":\"Article 112373\"},\"PeriodicalIF\":6.1000,\"publicationDate\":\"2025-07-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Diabetes research and clinical practice\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0168822725003870\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetes research and clinical practice","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0168822725003870","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Diabetic retinopathy and chronic kidney disease synergistically increase the risk of incident cardiovascular disease in type 2 diabetes: Insights from two cohort studies
Aims
Chronic kidney disease (CKD) is a well-established cardiovascular risk factor for type 2 diabetes (T2D); however, the role of diabetic retinopathy (DR) remains unclear. This study evaluated the individual and combined effects of DR and CKD on cardiovascular disease (CVD) in T2D.
Methods
We analyzed individuals with T2D and no prior CVD from the Korean NHIS cohort (n = 2,064,406) and the UK Biobank (n = 21,350). The primary outcome was a composite of cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke.
Results
In the Korean cohort, adjusted hazard ratios (aHRs) for the primary outcome were elevated in those with PDR (aHR 1.37), CKD (aHR 1.36), and even more so when both were present (aHR 2.21), compared to individuals without DR or CKD. Similar results were observed in the UK Biobank. The effect of PDR on CVD was strongest in younger individuals, with aHRs of 3.28 (<40 years), 1.77 (40–64 years), and 1.29 (≥65 years) (Reference: No DR in each age group).
Conclusions
PDR and CKD, both independently and in combination, increase cardiovascular risk in individuals with T2D, particularly among younger age groups. These findings support incorporating PDR into cardiovascular risk assessment and management.
期刊介绍:
Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.