The relationship between diabetic retinopathy and diabetic nephropathy in type 2 diabetes

Front Endocrinol (Lausanne). 2024 Jan 26:15:1292412. doi: 10.3389/fendo.2024.1292412. eCollection 2024.

Abstract

Context: Diabetic retinopathy (DR) and diabetic nephropathy (DN), are major microvascular complications of diabetes. DR is an important predictor of DN, but the relationship between the severity of DR and the pathological severity of diabetic glomerulopathy remains unclear.

Objective: To investigate the relationship between severity of diabetic retinopathy (DR) and histological changes and clinical indicators of diabetic nephropathy (DN) in patients with type 2 diabetes mellitus (T2DM).

Methods: Patients with T2DM (n=272) who underwent a renal biopsy were eligible. Severity of DR was classified as non-diabetic retinopathy, non-proliferative retinopathy, and proliferative retinopathy (PDR). Relationship between DN and DR and the diagnostic efficacy of DR for DN were explored.

Results: DN had a higher prevalence of DR (86.4%) and DR was more severe. The sensitivity and specificity of DR in DN were 86.4% and 78.8%, while PDR was 26.4% and 98.5%, respectively. In DN patients, the severity of glomerular lesions (p=0.001) and prevalence of KW nodules (p<0.001) significantly increased with increasing severity of DR. The presence of KW nodules, lower hemoglobin levels, and younger age were independent risk factors associated with more severe DR in patients with DN.

Conclusion: DR was a good predictor of DN. In DN patients, the severity of DR was associated with glomerular injury, and presence of KW nodules, lower hemoglobin levels and younger age were independent risk factors associated with more severe DR.

Trial registration: ClinicalTrails.gov, NCT03865914.

Keywords: KW nodules; diabetes mellitus; diabetic nephropathy; diabetic retinopathy; non-diabetic renal disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Diabetes Mellitus, Type 2* / complications
  • Diabetic Nephropathies* / diagnosis
  • Diabetic Nephropathies* / epidemiology
  • Diabetic Nephropathies* / etiology
  • Diabetic Retinopathy* / diagnosis
  • Diabetic Retinopathy* / epidemiology
  • Diabetic Retinopathy* / etiology
  • Hemoglobins
  • Humans
  • Risk Factors

Substances

  • Hemoglobins

Associated data

  • ClinicalTrials.gov/NCT03865914

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by Science & Technology Project of Beijing, China (No. Z221100007422121, D171100002817002), Beijing Natural Science Foundation (No. L222133, L232122), and National Natural Science Foundation of China (No. 62250001, 81700629).