Correlation between retinal vascular geometric parameters and pathologically diagnosed type 2 diabetic nephropathy
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PROVIDER: S-EPMC11292218 | biostudies-literature | 2024 Jul
REPOSITORIES: biostudies-literature
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Project description:To investigate the relationship between geometrical changes of retinal vessels and diabetic peripheral neuropathy (DPN), and to determine the effectiveness of retinal vascular geometry analysis and vibration perception threshold (VPT) for DPN assessment. Type 2 diabetes patients (n = 242) were categorized by stage of DPN. VPT and fundus photography was performed to obtain retinal vascular geometry parameters. The risk factors for DPN and the correlation between DPN stages were analyzed. The efficiency of the retinal vascular geometric parameters obtained with VPT as a diagnostic tool for DPN was examined. Stages of DPN showed a linear correlation with VPT (r = 0.818), central retinal vein equivalent (CRVE) (r = 0.716), and fractal dimension arterioles (DFa) (r = - 0.769). VPT, CRVE, DFa, and fractal dimension veins (DFv) showed high sensitivity (80%, 55%, 82%, and 67%, respectively) and specificity (92%, 93%, 82%, and 80%, respectively) for DPN diagnosis. Good agreement was observed between combined use of geometric parameters (CRVE, DFa and DFv) and VPT (Kappa value 0.430). The detection rate of DPN with combined use of geometric parameters of retinal vessels (64.88%) was significantly higher than that with use of VPT (47.52%). Retinal vascular geometry changes demonstrated significant correlation with DPN severity. VPT, CRVE, DFa, and DFv may provide insights for understanding DPN.
| S-EPMC7990935 | biostudies-literature
Project description:IntroductionBy using spectral domain optical coherence tomography (SD-OCT) to measure retinal blood vessels. The correlation between the changes of retinal vascular structure and the degree of diabetic nephropathy is analyzed with a full-pixel Semantic segmentation method.MethodsA total of 120 patients with diabetic nephropathy who were treated in the nephrology department of Quzhou People's Hospital from March 2023 to March 2024 were selected and divided into three groups according to the urinary albumin creatinine ratio (UACR). The groups included simple diabetes group (UACR < 30 mg/g), microalbuminuria group (30 mg/g ≤ UACR <300 mg/g) and macroalbuminuria group (UACR ≥300 mg/g). SD-OCT was used to scan the arteries and veins in the superior temporal area B of the retina. The semantic segmentation method built into the SD-eye software was used to automatically identify the morphology and structure of the vessels and calculate the parameters of arteriovenous vessels. The parameters of arteriovenous vessels are as follows: outer diameter of the retinal artery (RAOD); inner diameter of the retinal artery (RALD); arterial wall thickness (AWT); arterial wall to lumen ratio (AWLR); cross sectional area of arterial wall (AWCSA); retinal vein outer diameter (RVOD); retinal vein inner diameter (RVLD); vein wall thickness (VWT); vein wall to lumen ratio (VWLR); cross sectional area of vein wall (VWCSA). Statistical analysis software was used to compare and analyze the parameters of retinal arteriovenous vessels of the three groups.ResultsThe study revealed statistically significant differences in RAOD and RALD among the three groups (p < 0.05) with the RAOD and RALD of the macroalbuminuria group and microalbuminuria group being lower than those of the simple diabetes group. Conversely, there were no significant differences in AWT, AWLR and AWCSA among the three groups (p > 0.05). Additionally, the differences in RVOD and RVLD among the three groups were found to be statistically significant (p < 0.05) with the RVOD and RVLD of the simple diabetes group being lower than those of the microalbuminuria group and macroalbuminuria group. No significant differences were observed in VWT and VWL among the groups. Additionally, RVOD and RVLD were weakly associated with UACR (R = 0.247, p = 0.007; R = 0.210, p = 0.021). Full-pixel semantic segmentation method combined with OCT images is a new retinal vascular scanning technology, which can be used as a new method for early diagnosis of diabetic nephropathy. The structural changes of retinal vessels can be used to predict the severity of diabetic nephropathy during the development of diabetic nephropathy.
| S-EPMC11540694 | biostudies-literature
Project description:BackgroundTo explore the characteristics of retina microvascular changes in patients with diabetic nephropathy (DN) and its risk factors.MethodsRetrospective, observational study. 145 patients with type 2 diabetic mellitus (DM) and DN were included in the study. Demographic and clinical parameters were obtained from medical records. Presence of diabetic retinopathy (DR), hard exudates (HEs) and diabetic macular edema (DME) were evaluated according to the color fundus images, optical coherence tomography (OCT) and fluorescence angiography (FFA).ResultsDR accounted for 61.4% in type 2 DM patients with DN, of which proliferative diabetic retinopathy (PDR) accounted for 23.6% and sight threatening DR accounted for 35.7%. DR group had significantly higher levels of low-density lipoprotein cholesterol (LDL-C) (p = 0.004), HbA1c (P = 0.037), Urine albumin creatine ratio (ACR) (p < 0.001) and lower level of estimated glomerular filtration rate (eGFR) (P = 0.013). Logistic regression analysis showed DR was significantly associated with ACR stage (p = 0.011). Subjects with ACR stage3 had higher incidence of DR compared with subjects with ACR stage1 (OR = 24.15, 95%CI: 2.06-282.95). 138 eyes of 138 patients were analyzed for HEs and DME, of which 23.2% had HEs in posterior pole and 9.4% had DME. Visual acuity was worse in HEs group than in non-HEs group. There was significant difference in the LDL-C cholesterol level, total cholesterol (CHOL) level and ACR between HEs group and non-HEs group.ConclusionsA relatively higher prevalence of DR was found in type 2 DM patients with DN. ACR stage could be recognized as a risk factor for DR in DN patients. Patients with DN needs ophthalmic examination more timely and more frequently.
| S-EPMC10161482 | biostudies-literature
Project description:BackgroundDiabetic kidney disease (DKD) has become the largest cause of end-stage kidney disease. Early and accurate detection of DKD is beneficial for patients. The present detection depends on the measurement of albuminuria or the estimated glomerular filtration rate, which is invasive and not optimal; therefore, new detection tools are urgently needed. Meanwhile, a close relationship between diabetic retinopathy and DKD has been reported; thus, we aimed to develop a novel detection algorithm for DKD using artificial intelligence technology based on retinal vascular parameters combined with several easily available clinical parameters in patients with type-2 diabetes.MethodsA total of 515 consecutive patients with type-2 diabetes mellitus from Xiangyang Central Hospital were included. Patients were stratified by DKD diagnosis and split randomly into either the training set (70%, N = 360) or the testing set (30%, N = 155) (random seed = 1). Data from the training set were used to develop the machine learning algorithm (MLA), while those from the testing set were used to validate the MLA. Model performances were evaluated.ResultsThe MLA using the random forest classifier presented optimal performance compared with other classifiers. When validated, the accuracy, sensitivity, specificity, F1 score, and AUC for the optimal model were 84.5%(95% CI 83.3-85.7), 84.5%(82.3-86.7), 84.5%(82.7-86.3), 0.845(0.831-0.859), and 0.914(0.903-0.925), respectively.ConclusionsA new machine learning algorithm for DKD diagnosis based on fundus images and 8 easily available clinical parameters was developed, which indicated that retinal vascular changes can assist in DKD screening and detection.
| S-EPMC10617171 | biostudies-literature
Project description:Rationale & objectiveA causal relationship concerning diabetic retinopathy (DR) and diabetic nephropathy (DN) has been studied in many epidemiological observational studies. We conducted a two-sample mendelian randomization study from the perspective of genetics to assess these associations.Methods20 independent single nucleotide polymorphisms (SNPs) associated with diabetic retinopathy were selected from the FinnGen consortium. Summary-level data for diabetic nephropathy were obtained from the publicly available genome-wide association studies (GWAS) database, FinnGen and CKDGen consortium. Inverse variance weighted (IVW) was selected as the primary analysis. MR-Egger, weighted median (WM), simple mode and weighted mode were used as complementary methods to examine causality. Additionally, sensitivity analyses including Cochran's Q test, MR-Egger, MR-Pleiotropy Residual Sum and Outlier (MR-PRESSO), and leave-one-out analyses were conducted to guarantee the accuracy and robustness of our MR analysis.ResultsOur current study demonstrated positive associations of genetically predicted diabetic retinopathy with diabetic nephropathy (OR=1.32; P=3.72E-11), type 1 diabetes with renal complications (OR=1.96; P= 7.11E-11), and type 2 diabetes with renal complications (OR=1.26, P=3.58E-04). Further subtype analysis and multivariate mendelian randomization (MVMR) also reached the same conclusion. A significant casualty with DN was demonstrated both in non-proliferative DR (OR=1.07, P=0.000396) and proliferative DR (OR=1.67, P=3.699068E-14). All the findings were robust across several sensitivity analyses.ConclusionConsistent with previous clinical studies, our findings revealed a positive correlation between DR and DN, providing genetic evidence for the non-invasive nature of DR in predicting DN.
| S-EPMC10646564 | biostudies-literature
Project description:BackgroundRenal injuries in patients with diabetes include diabetic nephropathy (DN) and non-diabetic renal diseases (NDRD). The value of a clinical diagnosis of DN and NDRD remains inconclusive. We conducted a meta-analysis of the literature to identify predictive factors of NDRD and to compare the clinical characteristics of DN and NDRD for differential diagnosis.MethodsWe searched PubMed (1990 to January 2012), Embase (1990 to February 2009), and CNKI (1990 to January 2012) to identify studies that enrolled patients with DN and NDRD. Then, the quality of the studies was assessed, and data were extracted. The results were summarized as odds ratios (ORs) for dichotomous outcomes and weighted mean differences (WMDs) for continuous outcomes.ResultsTwenty-six relevant studies with 2,322 patients were included. The meta-analysis showed that the absence of diabetic retinopathy (DR) predicts NDRD (OR, 0.15; 95% confidence interval [CI], 0.09-0.26, p<0.00001). A shorter duration of diabetes mellitus (DM) also predicted NDRD (weighted mean difference, -34.67; 95% CI, -45.23--24.11, p<0.00001). The levels of glycosylated hemoglobin (HbA1C%), blood pressure (BP), and total cholesterol were lower in patients with NDRD, whereas triglycerides and body mass index were higher. Other clinical parameters, including age, 24-h urinary protein excretion, serum creatinine, creatinine clearance, blood urea nitrogen, and glomerular filtration rate were not different between patients with NDRD and DN.ConclusionsWe identified that the absence of DR, shorter duration of DM, lower HbA1C, and lower BP may help to distinguish NDRD from DN in patients with diabetes. This could assist clinicians in making a safe and sound diagnosis and lead to more effective treatments.
| S-EPMC3653878 | biostudies-literature
Project description:Correlation of vascular endothelial function and coagulation factors with renal function and inflammatory factors in patients with diabetic nephropathy was analyzed. A total of 86 patients diagnosed with diabetes mellitus (DM) and admitted to the 89th Hospital of the People's Liberation Army (Weifang, China) from March 2014 to May 2017 were selected. Among them, 38 patients complicated with nephropathy were divided into the observation group and 48 patients without nephropathy into the control group. The general data of patients were collected, and the relevant biochemical indexes, vascular endothelial function, coagulation factors and renal function indicators and the levels of inflammatory factors were determined. In the observation group, the duration of DM was longer than that in the control group, and the levels of glycated hemoglobin (HbA1c), fasting plasma glucose (FPG) and fasting insulin (FINS), level of fibrinogen (FIB) were higher than those in the control group (p<0.05). Homocysteine (Hcy) and brachial artery blood flow in the observation group were higher than those in the control group. The levels of nitric oxide (NO) and flow-mediated dilation (FMD) were lower than those in the control group (p<0.05). Activated partial thromboplastin time (APTT) in the observation group was shorter than that in the control group (p<0.05). The levels of cystatin-C (Cys-C), serum creatinine (SCr), urea and ?2-microglobulin, levels of C-reactive protein (CRP), tumor necrosis factor-? (TNF-?) and interleukin-6 (IL-6) in peripheral serum in the observation group were greatly higher than those in the control group (p<0.05). It was concluded via the correlation analysis of vascular endothelial function and coagulation factor with renal function and inflammatory factors that SCr and CRP were negatively correlated with NO, and SCr and CRP were positively correlated with FIB. Serum inflammatory factors, coagulation function and vascular endothelial function are closely related to diabetic nephropathy, which are good reference indexes for the assessment of diabetic nephropathy.
| S-EPMC6200961 | biostudies-other
Project description:BackgroundGlomerular podocyte number declines and urinary excretion of podocytes increases as kidney disease progresses in persons with type 2 diabetes mellitus (T2DM).MethodsUsing high-power electron microscopy, we quantified podocyte detachment in T2DM.ResultsWe evaluated 106 glomeruli (range 1-6 per subject) from 40 Pima Indian subjects with T2DM enrolled in a clinical trial. On high-power electron micrographs, 35% of the subjects had no evidence of podocyte detachment. Among the remaining subjects, the median percentage of basement membrane with podocyte detachment was 0.62% (interquartile range = 0.32-1.52%).ConclusionPodocyte detachment from the glomerular basement membrane has been described and measured in type 1 diabetes mellitus using a different method. We now document podocyte detachment microscopically and quantify it morphometrically in humans with T2DM. The findings offer quantitative histologic support to a potential mechanism for the functional impairment, and possibly the sclerosis of glomeruli, in diabetic glomerular injury.
| S-EPMC3121550 | biostudies-literature
Project description:PurposeTo measure the effect of nonproliferative diabetic retinopathy (NPDR) on retinal branching. To compare vascular branching in healthy and diabetic subjects with established biophysical models.MethodsVascular bifurcations in arteries and veins were imaged in 17 NPDR and 26 healthy subjects with the Indiana adaptive optics scanning laser ophthalmoscope (AOSLO). Vessel measurements were grouped according to parent vessel diameters into large (≤50 ∼ <100 μm) and small (≤20 ∼ <50 μm) sizes. Vessel diameters and bifurcation angles were measured manually. Vascular diameters were compared with predictions of Murray's law using curve fitting. For analysis of bifurcation angles, two models from Zamir were compared: one based on the power required for blood pumping, the other based on drag force between blood and vascular wall.ResultsFor normal larger vessels, the exponent relating the parent and daughter branching diameters was significantly less than the value of 3 predicted by Murray's law (arteries: 2.59; veins: 1.95). In NPDR, the best-fit exponent was close to 3 for arteries but close to 2 in healthy subjects in veins, (arteries: 3.09; veins: 2.16). For both small arteries and veins, diabetics' exponent differed from healthy subjects (P < 0.01). Bifurcation angles in the healthy subjects (78° ± with a standard error (SE) of 0.9°) were not much different than in NPDR (79° ± SE 1.3°). The model based on minimizing pumping power predicted the measurements better than the one minimizing the vascular drag and lumen surface area.ConclusionsThe relation between parent and daughter branch diameters changes in diabetes, but the branching angles do not.
| S-EPMC6024667 | biostudies-literature
Project description:Gene expression profiling in glomeruli from human kidneys with diabetic nephropathy Keywords = Diabetes Keywords = kidney Keywords = glomeruli Keywords: other
2004-04-01 | GSE1009 | GEO