1. Bacterial infections as novel risk factors of severe diabetic retinopathy in individuals with type 1 diabetes
- Author
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Carol Forsblom, Kustaa Hietala, Johan R Simonsen, Asko Järvinen, Markku Lehto, Per-Henrik Groop, Valma Harjutsalo, HUS Abdominal Center, Nefrologian yksikkö, HUS Inflammation Center, Department of Medicine, Clinicum, Infektiosairauksien yksikkö, Faculty of Medicine, University of Helsinki, Research Programs Unit, and Per Henrik Groop / Principal Investigator
- Subjects
Lipopolysaccharides ,Male ,CHRONIC KIDNEY-DISEASE ,0301 basic medicine ,Epidemiology ,Antibiotics ,ADHESION ,Eye Infections, Bacterial ,Diabetic nephropathy ,0302 clinical medicine ,Risk Factors ,Cumulative incidence ,Prospective Studies ,Medical record ,Leukostasis ,ASSOCIATION ,Diabetic retinopathy ,Clinical Science ,Middle Aged ,Sensory Systems ,3. Good health ,LEUKOSTASIS ,Female ,Infection ,Adult ,medicine.medical_specialty ,medicine.drug_class ,RENAL-INSUFFICIENCY ,Young Adult ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,Internal medicine ,medicine ,Humans ,3125 Otorhinolaryngology, ophthalmology ,Inflammation ,Type 1 diabetes ,Diabetic Retinopathy ,Treatment Lasers ,business.industry ,MORTALITY ,medicine.disease ,Ophthalmology ,Diabetes Mellitus, Type 1 ,030104 developmental biology ,ATHEROSCLEROSIS ,030221 ophthalmology & optometry ,business - Abstract
Background/AimsDiabetic retinopathy (DR) is associated and shares many risk factors with other diabetic complications, including inflammation. Bacterial infections, potent inducers of inflammation have been associated with the development of diabetic complications apart from DR. Our aim was to investigate the association between bacterial infections and DR.MethodsAdult individuals with type 1 diabetes (n=1043) were recruited from the Finnish Diabetic Nephropathy Study (FinnDiane), a prospective follow-up study. DR was defined as incident severe diabetic retinopathy (SDR), identified as first laser treatment. Data on DR were obtained through fundus photographs and medical records, data on bacterial infections from comprehensive national registries (1 January 1995 to 31 December 2015). Risk factors for DR and serum bacterial lipopolysaccharide (LPS) activity were determined at baseline.ResultsIndividuals with incident SDR (n=413) had a higher mean number of antibiotic purchases/follow-up year compared with individuals without incident SDR (n=630) (0.92 [95% CI 0.82 to 1.02] vs 0.67 [0.62–0.73], p=0.02), as well as higher levels of LPS activity (0.61 [0.58–0.65] vs 0.56 [0.54–0.59] EU/mL, p=0.03). Individuals with on average ≥1 purchase per follow-up year (n=269) had 1.5 times higher cumulative incidence of SDR, compared with individuals with ConclusionBacterial infections are associated with an increased risk of incident SDR in type 1 diabetes.
- Published
- 2020