Diabetic retinopathy and the risk of coronary heart disease: The atherosclerosis risk in communities study

Ning Cheung, Jin Wang Jie, Ronald Klein, David J. Couper, A. Richey Sharrett, Tien Y. Wong

Research output: Contribution to journalArticle

Abstract

OBJECTIVE - We sought to examine the relation of diabetic retinopathy to incident coronary heart disease (CHD). RESEARCH DESIGN AND METHODS - A population-based, prospective cohort study consisting of 1,524 middle-aged individuals with type 2 diabetes without prevalent CHD and stroke at baseline was conducted. Diabetic retinopathy signs were graded from retinal photographs according to the Early Treatment for Diabetic Retinopathy Study severity scale. Incident CHD events (myocardial infarction, fatal CHD, or coronary revascularization) were identified and validated following standardized protocols. RESULTS - In our study, 214 (14.7%) participants had diabetic retinopathy. Over an average follow-up of 7.8 years, there were 209 (13.7%) incident CHD events. After controlling for age, sex, race, study center, fasting glucose, A1C, duration of diabetes, blood pressure, antihypertensive treatment, cigarette smoking, BMI, and lipid profile, the presence of diabetic retinopathy was associated with a twofold higher risk of incident CHD events (hazard rate ratio [HR] 2.07 [95% CI 1.38-3.11]) and a threefold higher risk of fatal CHD (3.35 [1.40-8.01]). Further adjustments for inflammatory markers, carotid artery intima-media thickness, or nephropathy had minimal impact on the association. The increased risk of CHD was significant in both men (1.89 [1.08-3.31]) and women (2.16 [1.16-4.02]) with diabetic retinopathy. CONCLUSIONS - In individuals with type 2 diabetes, the presence of retinopathy signifies an increased CHD risk, independent of known risk factors. Our data support the role of microvascular disease in the pathogenesis of CHD in diabetes.

Original languageEnglish (US)
Pages (from-to)1742-1746
Number of pages5
JournalDiabetes Care
Volume30
Issue number7
DOIs
StatePublished - Jul 2007

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Diabetic Retinopathy
Coronary Disease
Atherosclerosis
Type 2 Diabetes Mellitus
Carotid Intima-Media Thickness
Carotid Arteries
Antihypertensive Agents
Fasting
Cohort Studies
Research Design
Smoking
Stroke
Myocardial Infarction
Prospective Studies
Blood Pressure
Lipids
Glucose

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Cheung, N., Jie, J. W., Klein, R., Couper, D. J., Sharrett, A. R., & Wong, T. Y. (2007). Diabetic retinopathy and the risk of coronary heart disease: The atherosclerosis risk in communities study. Diabetes Care, 30(7), 1742-1746. https://doi.org/10.2337/dc07-0264

Diabetic retinopathy and the risk of coronary heart disease : The atherosclerosis risk in communities study. / Cheung, Ning; Jie, Jin Wang; Klein, Ronald; Couper, David J.; Sharrett, A. Richey; Wong, Tien Y.

In: Diabetes Care, Vol. 30, No. 7, 07.2007, p. 1742-1746.

Research output: Contribution to journalArticle

Cheung, N, Jie, JW, Klein, R, Couper, DJ, Sharrett, AR & Wong, TY 2007, 'Diabetic retinopathy and the risk of coronary heart disease: The atherosclerosis risk in communities study', Diabetes Care, vol. 30, no. 7, pp. 1742-1746. https://doi.org/10.2337/dc07-0264
Cheung, Ning ; Jie, Jin Wang ; Klein, Ronald ; Couper, David J. ; Sharrett, A. Richey ; Wong, Tien Y. / Diabetic retinopathy and the risk of coronary heart disease : The atherosclerosis risk in communities study. In: Diabetes Care. 2007 ; Vol. 30, No. 7. pp. 1742-1746.
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