Impact of Retinopathy and Systemic Vascular Comorbidities on All-Cause Mortality

Frontiers in Endocrinology

Xiaohong Yang¹  Zhuoting Zhu¹  Yifan Chen²  Jason Ha³  Xianwen Shang³  Wei Wang⁴  Mingguang He⁴  Jingyi He⁵ 

[1] Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China;Medical Sciences Division, University of Oxford, Oxford, United Kingdom;Ophthalmology, Department of Surgery, Centre for Eye Research Australia, University of Melbourne, Melbourne, VIC, Australia;State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China;Zhongshan School of Medicine, Sun Yat-sen Universtiy, Guangzhou, China;

关键词: retinopathy;    systemic vascular comorbidities;    diabetes;    hypertension;    kidney disease;    cardiovascular disease;   

DOI  :  10.3389/fendo.2021.750017

来源: DOAJ

【 摘 要 】

PurposeTo assess the impact of retinopathy and systemic vascular comorbidities on the all-cause mortality in a representative U.S. sample.MethodsA total of 5703 participants (≥40 years old) from the 2005-2008 National Health and Nutrition Examination Survey. The Early Treatment Diabetic Retinopathy Study grading scale was used to evaluate the retinopathy status. Systemic vascular comorbidities included diabetes mellitus (DM), high blood pressure (HBP), chronic kidney disease (CKD) and cardiovascular disease (CVD). Time to death was calculated as the time from baseline to either the date of death or censoring (December 31st, 2015), whichever came first. Risks of mortality were estimated using Cox proportional hazards models after adjusting for confounders and vascular comorbidities.ResultsAfter a median follow-up of 8.33 years (IQR: 7.50-9.67 years), there were 949 (11.8%) deaths from all causes. After adjusting for confounders, the presence of retinopathy predicted higher all-cause mortality (hazard ratio (HR), 1.41; 95% confidence interval (CI), 1.08-1.83). The all-cause mortality among participants with both retinopathy and systemic vascular comorbidities including DM (HR, 1.72; 95% CI, 1.21-2.43), HBP (HR, 1.47; 95% CI, 1.03-2.10), CKD (HR, 1.73; 95% CI, 1.26-2.39) and CVD (HR, 1.92; 95% CI, 1.21-3.04) was significantly higher than that among those without either condition. When stratified by diabetic or hypertension status, the co-occurrence of retinopathy and CKD or CVD further increased the all-cause mortality compared to those without either condition.ConclusionsThe co-occurrence of retinopathy and systemic vascular conditions predicted a further increase in the risk of mortality. More extensive vascular risk factor assessment and management are needed to detect the burden of vascular pathologies and improve long-term survival in individuals with retinopathy.

【 授权许可】

Unknown