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Discordance in risk factors for the progression of diabetic retinopathy and diabetic nephropathy in patients with type 2 diabetes mellitus.

AIMS: We aimed to investigate whether there are differences in the risk factors or markers for the progression of diabetic retinopathy (DR) and diabetic nephropathy (DN) in type 2 diabetes mellitus (T2DM).

MATERIALS AND METHODS: We conducted a 3-year retrospective cohort study on 604 patients with T2DM mellitus. The outcomes were the progression of DR (worsening of the DR stage) and DN [an estimated glomerular filtration rate (eGFR) decline >12%] at the 3-year follow-up. Mean hemoglobin A1c (HbA1c) level, and HbA1c variability (HbA1c-VAR) were calculated.

RESULTS: Mean HbA1c and HbA1c-VAR levels were higher in the DR progressors (n = 67) than in the DR nonprogressors (n = 537). Mean HbA1c was a significant predictor for DR progression independent of the duration of diabetes and HbA1c-VAR levels. The urine albumin to creatinine ratio (ACR) at baseline and HbA1c-VAR levels were higher in the DN progressors (n = 34) than in the DN nonprogressors (n = 570). The triglyceride to high-density lipoprotein (HDL) cholesterol ratio at baseline tended to be higher in the DN progressors than in the DN nonprogressors. HbA1c-VAR levels and triglyceride to HDL cholesterol ratio were significant predictors for the DN progression independent of eGFR and urine ACR.

CONCLUSIONS: Average glycemia was significantly associated with progression of DR, whereas glycemic variability and dyslipidemia were significantly associated with progression of DN in T2DM. This article is protected by copyright. All rights reserved.

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