[Diabetic retinopathy and mortality in type 2 diabetic patients].
OBJECTIVE
This study was intended to assess the independent contribution of retinopathy to mortality in type 2 diabetic patients.


METHODS
Prospective cohort study. Type 2 diabetic patients with available fundus were included. The clinical end-point was total mortality. The main independent variable was baseline presence of background or proliferative retinopathy. Cox regression models were adjusted for age, sex, duration of diabetes, classical risk factors and baseline presence of nephropathy and cardiovascular disease.


RESULTS
458 patients were included (181 male, 277 females), with a median follow-up of 8 years (inter-quartile range, 6.7-9). There were 125 patients (27.3%) with background retinopathy and 46 (10%) with proliferative retinopathy. Mortality incidence rates per 1,000 patients-year were 20/1,000 (non retinopathy), 36.8/1,000 (background retinopathy) and 45.9/1,000 (proliferative retinopathy) with p = 0.0021. In the multivariate analysis, background retinopathy (HR = 1.87; 95% CI, 1.1-3.1; p = 0.019) and proliferative retinopathy (HR = 2.6; 95% CI, 1.3-5.1; p = 0.0048) were independent predictors of mortality. Other independent predictors were age (HR [1 year] = 1.13; 95% CI, 1.1-1.17; p < 0.0001), total cholesterol (HR [1 mmol/l] = 0.76; 95% CI, 0.6-0.97; p = 0.026), baseline insulin treatment (HR = 1.9; 95% CI, 1,1-3.2; p = 0.017) and baseline proteinuria (HR = 4.1; 95% CI, 2-8.5; p = 0.0001).


CONCLUSIONS
The presence of retinopathy increases the mortality risk in type 2 diabetic patients.
Gimeno Orna
José Antonio
JA
Hospital Comarcal, Alcañiz, Teruel, España. jagimeno@salud.aragon.es
Castro Alonso
Francisco J
FJ
Sánchez Vañó
Raquel
R
Latre Rebled
Beatriz
B
Lou Arnal
Luis M
LM
Molinero Herguedas
Edmundo
E
D000368:Aged; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000401:mortality*; D003930:Diabetic Retinopathy / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D016019:Survival Analysis