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

PURPOSE: To assess the impact of retinopathy and systemic vascular comorbidities on the all-cause mortality in a representative U.S. sample. METHODS: A total of 5703 participants (≥40 years old) from the 2005-2008 National Health and Nutrition Examination Survey. The Early Treatment Diabetic Retinop...

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Autores principales: Zhu, Zhuoting, Shang, Xianwen, Wang, Wei, Ha, Jason, Chen, Yifan, He, Jingyi, Yang, Xiaohong, He, Mingguang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8637619/
https://www.ncbi.nlm.nih.gov/pubmed/34867793
http://dx.doi.org/10.3389/fendo.2021.750017
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author Zhu, Zhuoting
Shang, Xianwen
Wang, Wei
Ha, Jason
Chen, Yifan
He, Jingyi
Yang, Xiaohong
He, Mingguang
author_facet Zhu, Zhuoting
Shang, Xianwen
Wang, Wei
Ha, Jason
Chen, Yifan
He, Jingyi
Yang, Xiaohong
He, Mingguang
author_sort Zhu, Zhuoting
collection PubMed
description PURPOSE: To assess the impact of retinopathy and systemic vascular comorbidities on the all-cause mortality in a representative U.S. sample. METHODS: A 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 31(st), 2015), whichever came first. Risks of mortality were estimated using Cox proportional hazards models after adjusting for confounders and vascular comorbidities. RESULTS: After 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. CONCLUSIONS: The 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.
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spelling pubmed-86376192021-12-03 Impact of Retinopathy and Systemic Vascular Comorbidities on All-Cause Mortality Zhu, Zhuoting Shang, Xianwen Wang, Wei Ha, Jason Chen, Yifan He, Jingyi Yang, Xiaohong He, Mingguang Front Endocrinol (Lausanne) Endocrinology PURPOSE: To assess the impact of retinopathy and systemic vascular comorbidities on the all-cause mortality in a representative U.S. sample. METHODS: A 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 31(st), 2015), whichever came first. Risks of mortality were estimated using Cox proportional hazards models after adjusting for confounders and vascular comorbidities. RESULTS: After 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. CONCLUSIONS: The 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. Frontiers Media S.A. 2021-11-18 /pmc/articles/PMC8637619/ /pubmed/34867793 http://dx.doi.org/10.3389/fendo.2021.750017 Text en Copyright © 2021 Zhu, Shang, Wang, Ha, Chen, He, Yang and He https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Endocrinology
Zhu, Zhuoting
Shang, Xianwen
Wang, Wei
Ha, Jason
Chen, Yifan
He, Jingyi
Yang, Xiaohong
He, Mingguang
Impact of Retinopathy and Systemic Vascular Comorbidities on All-Cause Mortality
title Impact of Retinopathy and Systemic Vascular Comorbidities on All-Cause Mortality
title_full Impact of Retinopathy and Systemic Vascular Comorbidities on All-Cause Mortality
title_fullStr Impact of Retinopathy and Systemic Vascular Comorbidities on All-Cause Mortality
title_full_unstemmed Impact of Retinopathy and Systemic Vascular Comorbidities on All-Cause Mortality
title_short Impact of Retinopathy and Systemic Vascular Comorbidities on All-Cause Mortality
title_sort impact of retinopathy and systemic vascular comorbidities on all-cause mortality
topic Endocrinology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8637619/
https://www.ncbi.nlm.nih.gov/pubmed/34867793
http://dx.doi.org/10.3389/fendo.2021.750017
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