title: Influence of Age at Diagnosis and Time-Dependent Risk Factors on the Development of Diabetic Retinopathy in Patients with Type 1 Diabetes.
abstract: Aim. To determine the influence of age at onset of type 1 diabetes and of traditional vascular risk factors on the development of diabetic retinopathy, in a cohort of patients who have been followed up after onset. Methods. Observational, retrospective study. The cohort consists of 989 patients who were followed up after diagnosis for a mean of 10.1 (SD: 6.8) years. The influence of age at diagnosis, glycemic control, duration of diabetes, sex, blood pressure, lipids, BMI, and smoking is analyzed using Cox univariate and multivariate models with fixed and time-dependent variables. Results. 135 patients (13.7%) developed diabetic retinopathy. The cumulative incidence was 0.7, 5.9, and 21.8% at 5-, 10-, and 15-year follow-up, respectively. Compared to the group with onset at age <10 years, the risk of retinopathy increased 2.5-, 3-, 3.3-, and 3.7-fold in the groups with onset at 10-14, 15-29, 30-44, and >44 years, respectively. During follow-up we also observed an association between diabetic retinopathy and HbA1c levels, HDL-cholesterol, and diastolic blood pressure. Conclusion. The rate of diabetic retinopathy is higher in patients who were older at type 1 diabetes diagnosis. In addition, we confirmed the influence of glycemic control, HDL-cholesterol, and diastolic blood pressure on the occurrence of retinopathy.
authors.affiliation: Department of Endocrinology and Nutrition, Complejo Hospitalario de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Calle Irunlarrea 3, Pamplona, 31008 Navarra, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Forga
authors.affiliation: Department of Endocrinology and Nutrition, Complejo Hospitalario de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Calle Irunlarrea 3, Pamplona, 31008 Navarra, Spain.
authors.forename: María José
authors.initials: MJ
authors.lastname: Goñi
authors.affiliation: Navarrabiomed, Fundación Miguel Servet, Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Calle Irunlarrea 3, Pamplona, 31008 Navarra, Spain.
authors.forename: Berta
authors.identifier: 0000-0002-7797-4845
authors.initials: B
authors.lastname: Ibáñez
authors.affiliation: Navarrabiomed, Fundación Miguel Servet, Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Calle Irunlarrea 3, Pamplona, 31008 Navarra, Spain.
authors.forename: Koldo
authors.initials: K
authors.lastname: Cambra
authors.affiliation: Department of Endocrinology and Nutrition, Complejo Hospitalario de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Calle Irunlarrea 3, Pamplona, 31008 Navarra, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: García-Mouriz
authors.affiliation: Department of Endocrinology and Nutrition, Complejo Hospitalario de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Calle Irunlarrea 3, Pamplona, 31008 Navarra, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Iriarte
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000175:diagnosis*; D003930:Diabetic Retinopathy / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult