title: Diabetic polyneuropathy and the risk of developing diabetic retinopathy: a nationwide, population-based study.
abstract: OBJECTIVE
  To assess the relationship between diabetic polyneuropathy (DPN) and the risk of diabetic retinopathy (DR).
  
  
  METHODS
  From 1997 to 2010, we identified 5031 newly diagnosed DPN patients and 20 124 controls matched for sex, age, and index year. Cox proportional hazards regression analyses were used to estimate the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of DR between the DPN patients and the non-DPN group. The adjusted hazard ratio was calculated and adjusted for age, sex, duration of diabetes and comorbidities of hypertension, cardiovascular disease and diabetic nephropathy.
  
  
  RESULTS
  The incidence rate of DR was 5.87-fold higher in the DPN patients than in the non-DPN group (44.0 vs. 7.22 per 1000 person-years), with an adjusted HR of 5.41(95% CI = 4.92-5.94). The DPN-to-non-DPN DR incidence rate ratio decreased with age (adjusted HR = 6.63 for subgroup younger than 65 years and adjusted HR = 3.91 for subgroup aged 65 years or older). Compared with the non-DPN group, the DPN patients had a 5.63-fold risk of non-proliferative DR (adjusted HR = 5.63, 95% CI = 5.11-6.21) and a 3.67-fold risk of proliferative DR (adjusted HR = 3.67, 95% CI = 2.57-5.23).
  
  
  CONCLUSIONS
  The patients with DPN had an increased risk of developing DR and advanced DR compared with the non-DPN group, particularly among the subgroup aged younger than 65 years.
authors.affiliation: Department of Ophthalmology, Shuang-Ho Hospital-Taipei Medical University, New Taipei City, Taiwan.
authors.forename: I-Chan
authors.initials: IC
authors.lastname: Lin
authors.affiliation: Division of Urology, Department of Surgery, Taipei Medical University- Shuang Ho Hospital, New Taipei City, Taiwan.|Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, New Taipei City, Taiwan.
authors.forename: Yuan-Hung
authors.initials: YH
authors.lastname: Wang
authors.affiliation: Management Office for Health Data, China Medical University, Taichung, Taiwan.
authors.forename: Cheng-Li
authors.initials: CL
authors.lastname: Lin
authors.affiliation: Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.
authors.forename: Yen-Jung
authors.initials: YJ
authors.lastname: Chang
authors.affiliation: Department of Ophthalmology, Cathay General Hospital, Taipei, Taiwan.
authors.forename: Shwu-Huey
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Ophthalmology, National Taiwan University Hospital, School of Medicine, Taipei, Taiwan.
authors.forename: I-Jong
authors.initials: IJ
authors.lastname: Wang
mesh_terms: D000368:Aged; D003929:Diabetic Neuropathies / Q000175:diagnosis / Q000453:epidemiology*; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology
keywords: diabetic polyneuropathy; diabetic retinopathy; population-based studies