# Diabetic retinopathy and diabetic kidney disease, either isolated or associated, impact on the 10-year risk of cardiovascular disease: are we dealing with similar conditions?

## TL;DR

This study explores how diabetic retinopathy and kidney disease affect cardiovascular risk in diabetes patients over 10 years.

## Contribution

It compares cardiovascular risk across groups with and without diabetic complications in type 1 and type 2 diabetes.

## Key findings

- Type 2 diabetes patients with kidney disease had higher cardiovascular risk than those with retinopathy alone.
- Renal involvement significantly increased cardiovascular risk in type 2 diabetes but not in type 1 diabetes.
- The study used the AHA cardiovascular disease score to assess 10-year risk in diabetes patients.

## Abstract

To evaluate the association between diabetic retinopathy, diabetic kidney
disease, and the 10-year risk of atherosclerotic cardiovascular disease in
patients with diabetes.

A cross-sectional study was performed involving patients diagnosed with
either type 1 or type 2 diabetes mellitus. Participants were classified into
four groups: DM (patients without diabetes-related complications), DR
(patients with diabetic retinopathy only), DKD (patients with diabetic
kidney disease only), and DR + DKD (patients with both diabetic retinopathy
and diabetic kidney disease). The primary outcome was the 10-year risk
assessment for cardiovascular events, calculated using the American Heart
Association’s atherosclerotic cardiovascular disease score.

A total of 571 patients were selected including 128 with type 1 diabetes
(average age of 39.4 ± 15.1 years; 48.4% female) and 443 with type 2
diabetes (average age of 59.5 ± 11.9 years; 66.4% female). Among the
participants with type 2 diabetes, the cardiovascular risk was 15.2 ±
14.6% for the DM group, 15.7 ± 10.7% for the DR group, 22.5 ±
16.7% for the DKD group, and 21.5 ± 15.1% for the DR + DKD group,
reflecting a significantly higher cardiovascular risk in the groups with
renal involvement (P <0.001). For those with type 1 diabetes, the DM
group had a risk of 6.1 ± 8.9%, the DR group 8.9 ±11.8%, the
DKD group 5.4 ± 8.8%, and the DR + DKD group 6.1 ± 9.5%. The
mean difference in risk between the groups was not statistically
significant.

In patients with type 2 diabetes, those with diabetic kidney disease appeared
to have a higher theoretical risk of cardiovascular disease compared to
those with only diabetic retinopathy.