Epidemiology of Retinopathy and other Complications in Long Term Type 1 Diabetes

长期 1 型糖尿病视网膜病变和其他并发症的流行病学

• 批准号: 8294242
• 负责人: BARBARA EDEN KLEIN
• 金额: $ 154.39万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-01 至 2017-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8294242
• 关键词: Address; Advanced Glycosylation End Products; Age-Years; Amputation; Antioxidants; Area; Atherosclerosis; Blood Pressure; Caliber; Candidate Disease Gene; Cardiovascular Diseases; Caring; Carotid Arteries; Characteristics; Charge; Cognition; Cohort Studies; Complications of Diabetes Mellitus; County; Creatinine; Data; Diabetes Mellitus; Diabetic Nephropathy; Diabetic Neuropathies; Diabetic Retinopathy; Diagnosis; Early Diagnosis; Early treatment; Electrocardiogram; Epidemiologic Studies; Epidemiology; Etiology; Fluorescence; Freezing; Frequencies; Funding; Fundus photography; Goals; Grant; Impaired cognition; Insulin; Insulin-Dependent Diabetes Mellitus; Intervention; Kidney Diseases; LDL Cholesterol Lipoproteins; Lead; Life; Lipids; Lower Extremity; Lysine; Measurement; Measures; Medial; Medical; Morbidity - disease rate; Myocardial Infarction; Neuropathy; Outcome; Oxidative Stress; Pathway interactions; Patients; Persons; Physicians; Preventive; Protocols documentation; Public Health; Retinal; Retinal Diseases; Risk; Risk Factors; Serum; Severities; Skin; Stress; Stroke; Testing; Therapeutic; Thick; Time; Ultrasonography; Vision; Visual Acuity; Wisconsin; abstracting; blood pressure regulation; cohort; experience; follow-up; glycemic control; high risk; improved; macular edema; modifiable risk; mortality; non-diabetic; oxidized low density lipoprotein; pentosidine; prevent; proliferative diabetic retinopathy; receptor for advanced glycation endproducts; retina blood vessel structure; stereoscopic

Epidemiology of Retinopathy and Other Complications in Long Term Type 1 Diabetes Project Summary / Abstract Persons with long term type 1 diabetes mellitus (T1DM) are at high risk of developing severe complications, presenting a pressing need to prevent these outcomes. It is, therefore, the goal of this epidemiological study to determine the relationship of specific underexamined risk factors for these complications that hold promise of diminishing these risks beyond the improvements achieved with current strategies. This study aims to measure advanced glycation endproducts (AGEs), receptors for AGEs (RAGE), carotid intimal-medial thickness, markers of antioxidant stress, and related candidate genes and their relationships to diabetic retinopathy, diabetic nephropathy, diabetic neuropathy, myocardial infarction, stroke, and cognitive dysfunction outcomes. In addition, the study will determine the relationship of retinal vessel diameters and severity of diabetic retinopathy to diabetic nephropathy, diabetic neuropathy, MI, stroke, and cognitive dysfunction. This proposal builds on a longitudinal representative cohort study of persons with long duration of T1DM participating in the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR, funded by NEI grants R01 EY03083 and R01 EY016379). The study included all insulin-taking persons with type 1 diabetes who were receiving primary medical care in an 11-county area of southwestern Wisconsin in 1979- 1980. They were examined in 1980-1982 and approximately every 5 years thereafter. Objective recording of retinopathy from stereoscopic fundus photography combined with a standardized grading, refraction and visual acuity, carotid artery ultrasound, electrocardiogram, measurement of skin intrinsic fluorescence, tests of cognition, and measurement of serum (e.g., AGEs [carboxymethyl lysine, pentosidine], soluble RAGE, oxidized low density lipoprotein cholesterol, creatinine) according to standardized protocols will be obtained in the proposed examination. In addition, we will measure AGEs, RAGE and oxidized low density lipoprotein cholesterol from frozen serum from previous exams to determine longitudinal associations with PDR and other complications. The new data from this study will provide a unique opportunity to determine why, independent of glycemic and blood pressure control, and despite long duration of T1DM, some persons have minimal to mild diabetic retinopathy, diabetic nephropathy, diabetic neuropathy, cognitive dysfunction, and less severe cardiovascular disease, while others have more severe complications. These data will be important to patients and their physicians in developing new interventions for managing type 1 diabetes and to public health practitioners charged with delivering preventive care.

长期1型糖尿病的视网膜病和其他并发症的流行病学 项目摘要 /摘要 长期1型糖尿病（T1DM）患有长期型糖尿病患者的高风险很高 并发症，提出了防止这些结果的紧迫需求。因此，这是这个目标 流行病学研究以确定特定不受污染的风险因素的关系 有望降低这些风险超出当前的改进的并发症 策略。这项研究旨在测量晚期糖基化最终产物（年龄），年龄的受体（RAGE）， 颈动脉内膜厚度，抗氧化应激的标志物以及相关的候选基因及其 与糖尿病性视网膜病，糖尿病性肾病，糖尿病神经病，心肌梗死，中风，中风的关系 和认知功能障碍结果。此外，该研究将确定视网膜血管的关系 糖尿病性视网膜病的直径和严重程度对糖尿病性肾病，糖尿病神经病，MI，中风和中风和 认知功能障碍。该提议建立在一项纵向代表队列研究的基础上 T1DM参与威斯康星州糖尿病性视网膜病变的流行病学研究（WESDR，资助） NEI Grants R01 EY03083和R01 EY016379）。该研究包括所有类型1的胰岛素吸引力 1979年在威斯康星州西南部11个县地区接受初级医疗的糖尿病 - 1980年。1980 - 1982年对它们进行了检查，此后大约每5年进行一次检查。客观记录 立体底部摄影的视网膜病变，结合了标准化的分级，折射率和视觉 敏锐度，颈动脉超声，心电图，皮肤内在荧光的测量，测试 认知和测量血清（例如，年龄[羧甲基赖氨酸，戊糖苷]，可溶性愤怒，氧化 低密度脂蛋白胆固醇，肌酐），根据标准化方案 拟议的检查。此外，我们将测量年龄，愤怒和氧化的低密度脂蛋白 来自先前检查的冷冻血清的胆固醇，以确定与PDR和其他的纵向关联 并发症。这项研究的新数据将提供一个独特的机会来确定为什么独立 血糖控制和血压控制，尽管T1DM的持续时间很长，但有些人对 轻度糖尿病性视网膜病，糖尿病性肾病，糖尿病神经病，认知功能障碍和不太严重 心血管疾病，而其他疾病则具有更严重的并发症。这些数据对患者很重要 以及他们的医生开发用于管理1型糖尿病和公共卫生的新干预措施 负责提供预防保健的从业者。