title: Retinal vascular lesions in patients of Caucasian and Asian origin with type 2 diabetes: baseline results from the ADVANCE Retinal Measurements (AdRem) study.
abstract: OBJECTIVE
  The objective of this study was to describe prevalent vascular retinal lesions among patients with type 2 diabetes enrolled in the ADVANCE Retinal Measurements (AdRem) study, a substudy of the Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation (ADVANCE) trial.
  
  
  METHODS
  Seven-field stereoscopic photographs of both eyes were obtained at the baseline assessment of the ADVANCE trial. All photographs were graded in a central reading center. Gradable retinal images were received from 1,605 patients.
  
  
  RESULTS
  The number of patients with any retinopathy (Early Treatment of Diabetic Retinopathy Study [ETDRS] score > or = 20) was 645 (40.2% [95% CI 37.8-42.6]); of these, 35 (2.2% [1.6-3.0]) had severe diabetic retinopathy (ETDRS score > or = 50). Focal arterial narrowing, venous beading, and arteriovenous nicking were present in 3.8, 5.1, and 9.8% of participants, respectively. Among participants included in this study, Chinese and South-Asian patients had more retinopathy than Caucasians, as defined both by ETDRS score (49.4, 46.0, and 31.3%, respectively; P < 0.001, adjusted for age, sex, A1C, systolic blood pressure, and duration of diabetes) and specific vascular lesions (e.g., arteriovenous nicking 12.3, 8.5, and 7.5%, respectively; adjusted P < 0.005). A1C, duration of diabetes, and systolic blood pressure were similarly associated with increased retinal lesions in Chinese, South-Asian, and Caucasian patients.
  
  
  CONCLUSIONS
  Using a sensitive diagnostic procedure, more than one-third of patients with type 2 diabetes enrolled in the AdRem study had retinal lesions at baseline. Despite differences in prevalence and severity of retinopathy among Chinese, South-Asian, and Caucasian patients included in this study, the cross-sectional associations among established risk factors for retinopathy and retinal lesions were similar across ethnic groups.
authors.affiliation: Department of Epidemiology, University Medical Center Groningen, P.O. Box 30.001, 9700RB Groningen, The Netherlands. r.p.stolk@epi.umcg.nl
authors.forename: Ronald P
authors.initials: RP
authors.lastname: Stolk
authors.forename: Mary J
authors.initials: MJ
authors.lastname: van Schooneveld
authors.forename: J Kennedy
authors.initials: JK
authors.lastname: Cruickshank
authors.forename: Alun D
authors.initials: AD
authors.lastname: Hughes
authors.forename: Alice
authors.initials: A
authors.lastname: Stanton
authors.forename: Juming
authors.initials: J
authors.lastname: Lu
authors.forename: Anushka
authors.initials: A
authors.lastname: Patel
authors.forename: Simon A McG
authors.initials: SA
authors.lastname: Thom
authors.forename: Diederick E
authors.initials: DE
authors.lastname: Grobbee
authors.forename: Johannes R
authors.initials: JR
authors.lastname: Vingerling
mesh_terms: D000328:Adult; D000368:Aged; D001208:Asia / Q000208:ethnology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications; D003930:Diabetic Retinopathy / Q000453:epidemiology*; D005006:Ethnicity; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D010781:Photography; D015995:Prevalence; D012160:Retina / Q000033:anatomy & histology; D012164:Retinal Diseases / Q000453:epidemiology*; D012171:Retinal Vessels / Q000503:physiopathology; D044465:White People / Q000706:statistics & numerical data*
chemical_list: D006442:Glycated Hemoglobin