Limits...
Age at onset and the risk of proliferative retinopathy in type 1 diabetes.

Hietala K, Harjutsalo V, Forsblom C, Summanen P, Groop PH, FinnDiane Study Gro - Diabetes Care (2010)

Bottom Line: When split into two groups, age at onset <15 years was associated with a higher long-term risk than age at onset >or=15 years (1.82 [1.40-2.36], P < 0.001).Age at onset significantly modifies the long-term risk of proliferative retinopathy.The highest risk is in age-at-onset group 5-14 years, whereas the lowest risk is in age-at-onset group 15-40 years.

View Article: PubMed Central - PubMed

Affiliation: Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, Helsinki, Finland.

ABSTRACT

Objective: Age at onset of type 1 diabetes influences the risk of microvascular complications. However, the long-term risk of proliferative retinopathy within the wide spectrum of age at onset of type 1 diabetes is less well known.

Research design and methods: A sample of 1,117 consecutively recruited patients was drawn from the FinnDiane Study population (4,800 patients). Type 1 diabetes was defined as age at onset

Results: The mean durations to proliferative retinopathy were 24.3 (22.7-25.9) years in the 0-4 years group, 20.1 (19.2-21.1) years in the 5-14 years group, and 21.6 (19.8-23.3) years in the 15-40 years group (P < 0.001). In a Cox regression model, with A1C, blood pressure, sex, and BMI as covariates, the highest risk of proliferative retinopathy was observed in the 5-14 years group (hazard ratio 1.90 [95% CI 1.45-2.48], P < 0.001). Diabetes onset 0-4 vs. 5-14 years made no difference in the long-term risk of proliferative retinopathy (P = 0.2). When split into two groups, age at onset <15 years was associated with a higher long-term risk than age at onset >or=15 years (1.82 [1.40-2.36], P < 0.001).

Conclusions: Age at onset significantly modifies the long-term risk of proliferative retinopathy. The highest risk is in age-at-onset group 5-14 years, whereas the lowest risk is in age-at-onset group 15-40 years.

Show MeSH

Related in: MedlinePlus

Kaplan-Meier survival analysis of the cumulative proportion of patients without proliferative retinopathy (PDR) in 1,117 patients stratified into three groups according to age at onset (P < 0.001, Mantel-Cox log-rank test).
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2875446&req=5

Figure 1: Kaplan-Meier survival analysis of the cumulative proportion of patients without proliferative retinopathy (PDR) in 1,117 patients stratified into three groups according to age at onset (P < 0.001, Mantel-Cox log-rank test).

Mentions: The Kaplan-Meier survival analysis stratified by various age-at-onset groups illustrates the progression to proliferative retinopathy (Fig. 1). Median times without proliferative retinopathy were 28.9 (24.6–33.2), 29.2 (26.1–32.2), and 37.8 (32.3–43.4) years in age-at-onset groups 0–4 years, 5–14 years, and 15–40 years, respectively (P < 0.001, Mantel-Cox log-rank test) (Fig. 1). Despite the initial delay in the progression to proliferative retinopathy in the youngest age-at-onset group, the long-term risk between age-at-onset groups 0–4 and 5–14 years was no different (P = 0.224, Mantel-Cox log-rank test) (Fig. 1). However, there was a significant difference when the patients were split into two groups according to age at onset before or after 15 years of age (P < 0.001, Mantel-Cox log-rank test). Median times without proliferative retinopathy were 28.9 (95% CI 26.4–31.4) years for the patients with age at onset before 15 years and 37.8 (95% CI 32.3–43.4) years for the patients with age at onset after 15 years. The risk of proliferative retinopathy was significantly higher in those patients with age at onset before 15 years versus after 15 years, when adjusted for the above-mentioned covariates (HR 1.82 [95% CI 1.40–2.36], P < 0.001).


Age at onset and the risk of proliferative retinopathy in type 1 diabetes.

Hietala K, Harjutsalo V, Forsblom C, Summanen P, Groop PH, FinnDiane Study Gro - Diabetes Care (2010)

Kaplan-Meier survival analysis of the cumulative proportion of patients without proliferative retinopathy (PDR) in 1,117 patients stratified into three groups according to age at onset (P < 0.001, Mantel-Cox log-rank test).
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2875446&req=5

Figure 1: Kaplan-Meier survival analysis of the cumulative proportion of patients without proliferative retinopathy (PDR) in 1,117 patients stratified into three groups according to age at onset (P < 0.001, Mantel-Cox log-rank test).
Mentions: The Kaplan-Meier survival analysis stratified by various age-at-onset groups illustrates the progression to proliferative retinopathy (Fig. 1). Median times without proliferative retinopathy were 28.9 (24.6–33.2), 29.2 (26.1–32.2), and 37.8 (32.3–43.4) years in age-at-onset groups 0–4 years, 5–14 years, and 15–40 years, respectively (P < 0.001, Mantel-Cox log-rank test) (Fig. 1). Despite the initial delay in the progression to proliferative retinopathy in the youngest age-at-onset group, the long-term risk between age-at-onset groups 0–4 and 5–14 years was no different (P = 0.224, Mantel-Cox log-rank test) (Fig. 1). However, there was a significant difference when the patients were split into two groups according to age at onset before or after 15 years of age (P < 0.001, Mantel-Cox log-rank test). Median times without proliferative retinopathy were 28.9 (95% CI 26.4–31.4) years for the patients with age at onset before 15 years and 37.8 (95% CI 32.3–43.4) years for the patients with age at onset after 15 years. The risk of proliferative retinopathy was significantly higher in those patients with age at onset before 15 years versus after 15 years, when adjusted for the above-mentioned covariates (HR 1.82 [95% CI 1.40–2.36], P < 0.001).

Bottom Line: When split into two groups, age at onset <15 years was associated with a higher long-term risk than age at onset >or=15 years (1.82 [1.40-2.36], P < 0.001).Age at onset significantly modifies the long-term risk of proliferative retinopathy.The highest risk is in age-at-onset group 5-14 years, whereas the lowest risk is in age-at-onset group 15-40 years.

View Article: PubMed Central - PubMed

Affiliation: Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, Helsinki, Finland.

ABSTRACT

Objective: Age at onset of type 1 diabetes influences the risk of microvascular complications. However, the long-term risk of proliferative retinopathy within the wide spectrum of age at onset of type 1 diabetes is less well known.

Research design and methods: A sample of 1,117 consecutively recruited patients was drawn from the FinnDiane Study population (4,800 patients). Type 1 diabetes was defined as age at onset

Results: The mean durations to proliferative retinopathy were 24.3 (22.7-25.9) years in the 0-4 years group, 20.1 (19.2-21.1) years in the 5-14 years group, and 21.6 (19.8-23.3) years in the 15-40 years group (P < 0.001). In a Cox regression model, with A1C, blood pressure, sex, and BMI as covariates, the highest risk of proliferative retinopathy was observed in the 5-14 years group (hazard ratio 1.90 [95% CI 1.45-2.48], P < 0.001). Diabetes onset 0-4 vs. 5-14 years made no difference in the long-term risk of proliferative retinopathy (P = 0.2). When split into two groups, age at onset <15 years was associated with a higher long-term risk than age at onset >or=15 years (1.82 [1.40-2.36], P < 0.001).

Conclusions: Age at onset significantly modifies the long-term risk of proliferative retinopathy. The highest risk is in age-at-onset group 5-14 years, whereas the lowest risk is in age-at-onset group 15-40 years.

Show MeSH
Related in: MedlinePlus