Retinal image measurements and their association with chronic kidney disease in Chinese patients with type 2 diabetes: the NCD study

Acta Diabetol. 2021 Mar;58(3):363-370. doi: 10.1007/s00592-020-01621-6. Epub 2020 Oct 24.

Abstract

Aims: Retinal and renal microcirculations are known to share similar physiological changes during early diabetes because of abnormal glucose metabolism and other processes. The retinal vasculature therefore may serve as potential biomarker for the early identification of those at high risk of chronic kidney disease (CKD) in diabetes.

Methods: Data from 1925 patients (aged 49.0 ± 10.3) with type 2 diabetes were analyzed. Various retinal image measurements (RIMs) were collected using a validated fully automated computer program. Multiple logistic regressions were performed to investigate the correlation between RIMs and CKD.

Results: In logistic regression adjusting for multiple variables, wider venular calibers in the central and middle zones and narrower arteriolar caliber in the central zone were associated with CKD (p < 0.001, p = 0.020, and p < 0.001, respectively). Increased arteriolar tortuosity was associated with CKD (p = 0.035). Multiple image texture measurements were also significantly associated with CKD.

Conclusions: Renal dysfunction in type 2 diabetes was associated with various retinal image measurements. These non-invasive image measurements may serve as potential biomarkers for the early identification and monitoring of individuals at high risk of CKD in the course of diabetes.

Keywords: Chronic kidney disease; Diabetes microvascular complications; Retinal image analysis.

MeSH terms

  • Adult
  • Aged
  • China / epidemiology
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / diagnostic imaging*
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Diabetes Mellitus, Type 2 / pathology
  • Diabetic Nephropathies / complications
  • Diabetic Nephropathies / diagnosis*
  • Diabetic Nephropathies / epidemiology
  • Diabetic Retinopathy / complications
  • Diabetic Retinopathy / diagnosis*
  • Diabetic Retinopathy / epidemiology
  • Diagnostic Techniques, Ophthalmological
  • Disease Progression
  • Female
  • Humans
  • Male
  • Microcirculation / physiology
  • Middle Aged
  • Predictive Value of Tests
  • Renal Insufficiency, Chronic / complications
  • Renal Insufficiency, Chronic / diagnosis*
  • Renal Insufficiency, Chronic / epidemiology
  • Retina / diagnostic imaging*
  • Retina / pathology
  • Retinal Vessels / diagnostic imaging
  • Retinal Vessels / pathology
  • Risk Factors
  • Sensitivity and Specificity