Presence of retinopathy and incident kidney and cardiovascular events in type 2 diabetes with normoalbuminuria – A post-hoc analysis of the PRIORITY randomized clinical trial

Viktor Rotbain Curovic; Nete Tofte; Morten Lindhardt; Katarina Adamova; Stephan J.L. Bakker; Joachim Beige; Joline W.J. Beulens; Andreas L. Birkenfeld; Gemma Currie; Christian Delles; Ingo Dimos; Lidmila Francová; Marie Frimodt-Møller; Peter Girman; Rüdiger Göke; Tine W. Hansen; Tereza Havrdova; Adriaan Kooy; Gozewijnw D. Laverman; Harald Mischak; Gerjan Navis; Giel Nijpels; Marina Noutsou; Alberto Ortiz; Aneliya Parvanova; Frederik Persson; John R. Petrie; Piero L. Ruggenenti; Femke Rutters; Ivan Rychlík; Justyna Siwy; Goce Spasovski; Marijn Speeckaert; Matias Trillini; Petra Zürbig; Heiko von der Leyen; Peter Rossing

doi:10.1016/j.jdiacomp.2023.108433

Presence of retinopathy and incident kidney and cardiovascular events in type 2 diabetes with normoalbuminuria – A post-hoc analysis of the PRIORITY randomized clinical trial

Viktor Rotbain Curovic^*, Nete Tofte, Morten Lindhardt, Katarina Adamova, Stephan J.L. Bakker, Joachim Beige, Joline W.J. Beulens, Andreas L. Birkenfeld, Gemma Currie, Christian Delles, Ingo Dimos, Lidmila Francová, Marie Frimodt-Møller, Peter Girman, Rüdiger Göke, Tine W. Hansen, Tereza Havrdova, Adriaan Kooy, Gozewijnw D. Laverman, Harald MischakGerjan Navis, Giel Nijpels, Marina Noutsou, Alberto Ortiz, Aneliya Parvanova, Frederik Persson, John R. Petrie, Piero L. Ruggenenti, Femke Rutters, Ivan Rychlík, Justyna Siwy, Goce Spasovski, Marijn Speeckaert, Matias Trillini, Petra Zürbig, Heiko von der Leyen, Peter Rossing,

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Aims: Baseline diabetic retinopathy (DR) and risk of development of microalbuminuria, kidney function decline, and cardiovascular events (CVEs) in type 2 diabetes. Methods: Post-hoc analysis of the PRIORITY study including 1758 persons with type 2 diabetes and normoalbuminuria followed for a median of 2.5 (IQR: 2.0–3.0) years. DR diagnosis included non-proliferative and proliferative abnormalities, macular oedema, or prior laser treatment. Cox models were fitted to investigate baseline DR presence with development of persistent microalbuminuria (urinary albumin-creatinine ratio > 30 mg/g); chronic kidney disease (CKD) G3 (eGFR <60 ml/min/1.73m²); and CVE. Models were adjusted for relevant risk factors. Results: At baseline, 304 (17.3 %) had DR. Compared to persons without DR, they were older (mean ± SD: 62.7 ± 7.7 vs 61.4 ± 8.3 years, p = 0.019), had longer diabetes duration (17.9 ± 8.4 vs. 10.6 ± 7.0 years, p < 0.001), and higher HbA_1c (62 ± 13 vs. 56 ± 12 mmol/mol, p < 0.001). The adjusted hazard ratios of DR at baseline for development of microalbuminuria (n = 197), CKD (n = 166), and CVE (n = 64) were: 1.50 (95%CI: 1.07, 2.11), 0.87 (95%CI: 0.56, 1.34), and 2.61 (95%CI: 1.44, 4.72), compared to without DR. Conclusions: Presence of DR in normoalbuminuric type 2 diabetes was associated with an increased risk of developing microalbuminuria and CVE, but not with kidney function decline.

Original language	English
Article number	108433
Journal	Journal of Diabetes and its Complications
Volume	37
Issue number	4
DOIs	https://doi.org/10.1016/j.jdiacomp.2023.108433
Publication status	Published - Apr 2023

Keywords

Albuminuria
Cardiovascular disease
Chronic kidney disease
Diabetic retinopathy
Risk stratification
Type 2 diabetes

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10.1016/j.jdiacomp.2023.108433

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Rotbain Curovic, V., Tofte, N., Lindhardt, M., Adamova, K., Bakker, S. J. L., Beige, J., Beulens, J. W. J., Birkenfeld, A. L., Currie, G., Delles, C., Dimos, I., Francová, L., Frimodt-Møller, M., Girman, P., Göke, R., Hansen, T. W., Havrdova, T., Kooy, A., Laverman, G. D. (2023). Presence of retinopathy and incident kidney and cardiovascular events in type 2 diabetes with normoalbuminuria – A post-hoc analysis of the PRIORITY randomized clinical trial. Journal of Diabetes and its Complications, 37(4), Article 108433. https://doi.org/10.1016/j.jdiacomp.2023.108433

@article{9dbdc2d6856c400ea1caa14bc63b4296,

title = "Presence of retinopathy and incident kidney and cardiovascular events in type 2 diabetes with normoalbuminuria – A post-hoc analysis of the PRIORITY randomized clinical trial",

abstract = "Aims: Baseline diabetic retinopathy (DR) and risk of development of microalbuminuria, kidney function decline, and cardiovascular events (CVEs) in type 2 diabetes. Methods: Post-hoc analysis of the PRIORITY study including 1758 persons with type 2 diabetes and normoalbuminuria followed for a median of 2.5 (IQR: 2.0–3.0) years. DR diagnosis included non-proliferative and proliferative abnormalities, macular oedema, or prior laser treatment. Cox models were fitted to investigate baseline DR presence with development of persistent microalbuminuria (urinary albumin-creatinine ratio > 30 mg/g); chronic kidney disease (CKD) G3 (eGFR <60 ml/min/1.73m2); and CVE. Models were adjusted for relevant risk factors. Results: At baseline, 304 (17.3 %) had DR. Compared to persons without DR, they were older (mean ± SD: 62.7 ± 7.7 vs 61.4 ± 8.3 years, p = 0.019), had longer diabetes duration (17.9 ± 8.4 vs. 10.6 ± 7.0 years, p < 0.001), and higher HbA1c (62 ± 13 vs. 56 ± 12 mmol/mol, p < 0.001). The adjusted hazard ratios of DR at baseline for development of microalbuminuria (n = 197), CKD (n = 166), and CVE (n = 64) were: 1.50 (95%CI: 1.07, 2.11), 0.87 (95%CI: 0.56, 1.34), and 2.61 (95%CI: 1.44, 4.72), compared to without DR. Conclusions: Presence of DR in normoalbuminuric type 2 diabetes was associated with an increased risk of developing microalbuminuria and CVE, but not with kidney function decline.",

keywords = "Albuminuria, Cardiovascular disease, Chronic kidney disease, Diabetic retinopathy, Risk stratification, Type 2 diabetes",

author = "{Rotbain Curovic}, Viktor and Nete Tofte and Morten Lindhardt and Katarina Adamova and Bakker, {Stephan J.L.} and Joachim Beige and Beulens, {Joline W.J.} and Birkenfeld, {Andreas L.} and Gemma Currie and Christian Delles and Ingo Dimos and Lidmila Francov{\'a} and Marie Frimodt-M{\o}ller and Peter Girman and R{\"u}diger G{\"o}ke and Hansen, {Tine W.} and Tereza Havrdova and Adriaan Kooy and Laverman, {Gozewijnw D.} and Harald Mischak and Gerjan Navis and Giel Nijpels and Marina Noutsou and Alberto Ortiz and Aneliya Parvanova and Frederik Persson and Petrie, {John R.} and Ruggenenti, {Piero L.} and Femke Rutters and Ivan Rychl{\'i}k and Justyna Siwy and Goce Spasovski and Marijn Speeckaert and Matias Trillini and Petra Z{\"u}rbig and {von der Leyen}, Heiko and Peter Rossing",

note = "Publisher Copyright: {\textcopyright} 2023 Elsevier Inc.",

year = "2023",

month = apr,

doi = "10.1016/j.jdiacomp.2023.108433",

language = "English",

volume = "37",

journal = "Journal of Diabetes and its Complications",

issn = "1056-8727",

publisher = "Elsevier",

number = "4",

}

Rotbain Curovic, V, Tofte, N, Lindhardt, M, Adamova, K, Bakker, SJL, Beige, J, Beulens, JWJ, Birkenfeld, AL, Currie, G, Delles, C, Dimos, I, Francová, L, Frimodt-Møller, M, Girman, P, Göke, R, Hansen, TW, Havrdova, T, Kooy, A, Laverman, GD, Mischak, H, Navis, G, Nijpels, G, Noutsou, M, Ortiz, A, Parvanova, A, Persson, F, Petrie, JR, Ruggenenti, PL, Rutters, F, Rychlík, I, Siwy, J, Spasovski, G, Speeckaert, M, Trillini, M, Zürbig, P, von der Leyen, H, Rossing, P 2023, 'Presence of retinopathy and incident kidney and cardiovascular events in type 2 diabetes with normoalbuminuria – A post-hoc analysis of the PRIORITY randomized clinical trial', Journal of Diabetes and its Complications, vol. 37, no. 4, 108433. https://doi.org/10.1016/j.jdiacomp.2023.108433

Presence of retinopathy and incident kidney and cardiovascular events in type 2 diabetes with normoalbuminuria – A post-hoc analysis of the PRIORITY randomized clinical trial. / Rotbain Curovic, Viktor; Tofte, Nete; Lindhardt, Morten et al.
In: Journal of Diabetes and its Complications, Vol. 37, No. 4, 108433, 04.2023.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Presence of retinopathy and incident kidney and cardiovascular events in type 2 diabetes with normoalbuminuria – A post-hoc analysis of the PRIORITY randomized clinical trial

AU - Rotbain Curovic, Viktor

AU - Tofte, Nete

AU - Lindhardt, Morten

AU - Adamova, Katarina

AU - Bakker, Stephan J.L.

AU - Beige, Joachim

AU - Beulens, Joline W.J.

AU - Birkenfeld, Andreas L.

AU - Currie, Gemma

AU - Delles, Christian

AU - Dimos, Ingo

AU - Francová, Lidmila

AU - Frimodt-Møller, Marie

AU - Girman, Peter

AU - Göke, Rüdiger

AU - Hansen, Tine W.

AU - Havrdova, Tereza

AU - Kooy, Adriaan

AU - Laverman, Gozewijnw D.

AU - Mischak, Harald

AU - Navis, Gerjan

AU - Nijpels, Giel

AU - Noutsou, Marina

AU - Ortiz, Alberto

AU - Parvanova, Aneliya

AU - Persson, Frederik

AU - Petrie, John R.

AU - Ruggenenti, Piero L.

AU - Rutters, Femke

AU - Rychlík, Ivan

AU - Siwy, Justyna

AU - Spasovski, Goce

AU - Speeckaert, Marijn

AU - Trillini, Matias

AU - Zürbig, Petra

AU - von der Leyen, Heiko

AU - Rossing, Peter

PY - 2023/4

Y1 - 2023/4

N2 - Aims: Baseline diabetic retinopathy (DR) and risk of development of microalbuminuria, kidney function decline, and cardiovascular events (CVEs) in type 2 diabetes. Methods: Post-hoc analysis of the PRIORITY study including 1758 persons with type 2 diabetes and normoalbuminuria followed for a median of 2.5 (IQR: 2.0–3.0) years. DR diagnosis included non-proliferative and proliferative abnormalities, macular oedema, or prior laser treatment. Cox models were fitted to investigate baseline DR presence with development of persistent microalbuminuria (urinary albumin-creatinine ratio > 30 mg/g); chronic kidney disease (CKD) G3 (eGFR <60 ml/min/1.73m2); and CVE. Models were adjusted for relevant risk factors. Results: At baseline, 304 (17.3 %) had DR. Compared to persons without DR, they were older (mean ± SD: 62.7 ± 7.7 vs 61.4 ± 8.3 years, p = 0.019), had longer diabetes duration (17.9 ± 8.4 vs. 10.6 ± 7.0 years, p < 0.001), and higher HbA1c (62 ± 13 vs. 56 ± 12 mmol/mol, p < 0.001). The adjusted hazard ratios of DR at baseline for development of microalbuminuria (n = 197), CKD (n = 166), and CVE (n = 64) were: 1.50 (95%CI: 1.07, 2.11), 0.87 (95%CI: 0.56, 1.34), and 2.61 (95%CI: 1.44, 4.72), compared to without DR. Conclusions: Presence of DR in normoalbuminuric type 2 diabetes was associated with an increased risk of developing microalbuminuria and CVE, but not with kidney function decline.

AB - Aims: Baseline diabetic retinopathy (DR) and risk of development of microalbuminuria, kidney function decline, and cardiovascular events (CVEs) in type 2 diabetes. Methods: Post-hoc analysis of the PRIORITY study including 1758 persons with type 2 diabetes and normoalbuminuria followed for a median of 2.5 (IQR: 2.0–3.0) years. DR diagnosis included non-proliferative and proliferative abnormalities, macular oedema, or prior laser treatment. Cox models were fitted to investigate baseline DR presence with development of persistent microalbuminuria (urinary albumin-creatinine ratio > 30 mg/g); chronic kidney disease (CKD) G3 (eGFR <60 ml/min/1.73m2); and CVE. Models were adjusted for relevant risk factors. Results: At baseline, 304 (17.3 %) had DR. Compared to persons without DR, they were older (mean ± SD: 62.7 ± 7.7 vs 61.4 ± 8.3 years, p = 0.019), had longer diabetes duration (17.9 ± 8.4 vs. 10.6 ± 7.0 years, p < 0.001), and higher HbA1c (62 ± 13 vs. 56 ± 12 mmol/mol, p < 0.001). The adjusted hazard ratios of DR at baseline for development of microalbuminuria (n = 197), CKD (n = 166), and CVE (n = 64) were: 1.50 (95%CI: 1.07, 2.11), 0.87 (95%CI: 0.56, 1.34), and 2.61 (95%CI: 1.44, 4.72), compared to without DR. Conclusions: Presence of DR in normoalbuminuric type 2 diabetes was associated with an increased risk of developing microalbuminuria and CVE, but not with kidney function decline.

KW - Albuminuria

KW - Cardiovascular disease

KW - Chronic kidney disease

KW - Diabetic retinopathy

KW - Risk stratification

KW - Type 2 diabetes

UR - http://www.scopus.com/inward/record.url?scp=85148723564&partnerID=8YFLogxK

U2 - 10.1016/j.jdiacomp.2023.108433

DO - 10.1016/j.jdiacomp.2023.108433

M3 - Article

C2 - 36841085

AN - SCOPUS:85148723564

SN - 1056-8727

VL - 37

JO - Journal of Diabetes and its Complications

JF - Journal of Diabetes and its Complications

IS - 4

M1 - 108433

ER -

Presence of retinopathy and incident kidney and cardiovascular events in type 2 diabetes with normoalbuminuria – A post-hoc analysis of the PRIORITY randomized clinical trial

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