Ethnicity, race, and baseline retinopathy correlates in the Veterans Affairs Diabetes Trial

Nicholas Emanuele, Jerome Sacks, Ronald Klein, Domenic Reda, Robert J. Anderson, William Duckworth, Carlos Abraira

Research output: Contribution to journalArticle

81 Citations (Scopus)

Abstract

OBJECTIVE - The Veterans Affairs Diabetes Trial (VADT) cohort is enriched with ∼20% Hispanics and 20% African Americans, affording a unique opportunity to study ethnic differences in retinopathy. RESEARCH DESIGN AND METHODS - Cross-sectional analyses on the baseline seven-field stereo fundus photos of 1,283 patients are reported here. Diabetic retinopathy scores are grouped into four classes of increasing severity: none (10-14), minimal nonproliferative diabetic retinopathy (NPDR) (15-39), moderate to severe NPDR (40-59), and proliferative diabetic retinopathy (60+). These four groups have also been dichotomized to none or minimal (10-39) and moderate to severe diabetic retinopathy (40+). RESULTS - The prevalence of diabetic retinopathy scores >40 was higher for Hispanics (36%) and African Americans (29%) than for non-Hispanic whites (22%). The difference between Hispanics and non-Hispanic whites was significant (P <0.05). Similarly, the prevalence of diabetic retinopathy scores >40 was significantly higher in African Americans than in non-Hispanic whites (P <0.05). These differences could not be accounted for by an imbalance in traditional risk factors such as age, duration of diagnosed diabetes, HbA1c (A1C), and blood pressure. Diabetic retinopathy seventy scores were also significantly associated with increasing years of disease duration, A1C, systolic and diastolic blood pressure, the degree of microalbuminuria, fibrinogen, and the percentage of patients with amputations. There was no relationship between retinopathy severity and the percentage of people who had strokes or cardiac revascularization procedures. There was an inverse relationship between retinopathy severity and total cholesterol, triglycerides, and plasminogen activator inhibitor-1 as well as with smoking history. Diabetic retinopathy scores were not associated with age. CONCLUSIONS - In addition to many well-known associations with retinopathy, a higher frequency of severe diabetic retinopathy was found in the Hispanic and African-American patients at entry into the VADT that is not accounted for by traditional risk factors for diabetic retinopathy, and these substantial ethnic differences remain to be explained.

Original languageEnglish
Pages (from-to)1954-1958
Number of pages5
JournalDiabetes Care
Volume28
Issue number8
DOIs
StatePublished - Aug 2005
Externally publishedYes

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Veterans
Diabetic Retinopathy
Hispanic Americans
African Americans
Blood Pressure
Plasminogen Activator Inhibitor 1
Amputation
Fibrinogen
Triglycerides
Research Design
Cross-Sectional Studies
Smoking
History
Stroke
Cholesterol

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Ethnicity, race, and baseline retinopathy correlates in the Veterans Affairs Diabetes Trial. / Emanuele, Nicholas; Sacks, Jerome; Klein, Ronald; Reda, Domenic; Anderson, Robert J.; Duckworth, William; Abraira, Carlos.

In: Diabetes Care, Vol. 28, No. 8, 08.2005, p. 1954-1958.

Research output: Contribution to journalArticle

Emanuele, N, Sacks, J, Klein, R, Reda, D, Anderson, RJ, Duckworth, W & Abraira, C 2005, 'Ethnicity, race, and baseline retinopathy correlates in the Veterans Affairs Diabetes Trial', Diabetes Care, vol. 28, no. 8, pp. 1954-1958. https://doi.org/10.2337/diacare.28.8.1954
Emanuele, Nicholas ; Sacks, Jerome ; Klein, Ronald ; Reda, Domenic ; Anderson, Robert J. ; Duckworth, William ; Abraira, Carlos. / Ethnicity, race, and baseline retinopathy correlates in the Veterans Affairs Diabetes Trial. In: Diabetes Care. 2005 ; Vol. 28, No. 8. pp. 1954-1958.
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abstract = "OBJECTIVE - The Veterans Affairs Diabetes Trial (VADT) cohort is enriched with ∼20{\%} Hispanics and 20{\%} African Americans, affording a unique opportunity to study ethnic differences in retinopathy. RESEARCH DESIGN AND METHODS - Cross-sectional analyses on the baseline seven-field stereo fundus photos of 1,283 patients are reported here. Diabetic retinopathy scores are grouped into four classes of increasing severity: none (10-14), minimal nonproliferative diabetic retinopathy (NPDR) (15-39), moderate to severe NPDR (40-59), and proliferative diabetic retinopathy (60+). These four groups have also been dichotomized to none or minimal (10-39) and moderate to severe diabetic retinopathy (40+). RESULTS - The prevalence of diabetic retinopathy scores >40 was higher for Hispanics (36{\%}) and African Americans (29{\%}) than for non-Hispanic whites (22{\%}). The difference between Hispanics and non-Hispanic whites was significant (P <0.05). Similarly, the prevalence of diabetic retinopathy scores >40 was significantly higher in African Americans than in non-Hispanic whites (P <0.05). These differences could not be accounted for by an imbalance in traditional risk factors such as age, duration of diagnosed diabetes, HbA1c (A1C), and blood pressure. Diabetic retinopathy seventy scores were also significantly associated with increasing years of disease duration, A1C, systolic and diastolic blood pressure, the degree of microalbuminuria, fibrinogen, and the percentage of patients with amputations. There was no relationship between retinopathy severity and the percentage of people who had strokes or cardiac revascularization procedures. There was an inverse relationship between retinopathy severity and total cholesterol, triglycerides, and plasminogen activator inhibitor-1 as well as with smoking history. Diabetic retinopathy scores were not associated with age. CONCLUSIONS - In addition to many well-known associations with retinopathy, a higher frequency of severe diabetic retinopathy was found in the Hispanic and African-American patients at entry into the VADT that is not accounted for by traditional risk factors for diabetic retinopathy, and these substantial ethnic differences remain to be explained.",
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T1 - Ethnicity, race, and baseline retinopathy correlates in the Veterans Affairs Diabetes Trial

AU - Emanuele, Nicholas

AU - Sacks, Jerome

AU - Klein, Ronald

AU - Reda, Domenic

AU - Anderson, Robert J.

AU - Duckworth, William

AU - Abraira, Carlos

PY - 2005/8

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N2 - OBJECTIVE - The Veterans Affairs Diabetes Trial (VADT) cohort is enriched with ∼20% Hispanics and 20% African Americans, affording a unique opportunity to study ethnic differences in retinopathy. RESEARCH DESIGN AND METHODS - Cross-sectional analyses on the baseline seven-field stereo fundus photos of 1,283 patients are reported here. Diabetic retinopathy scores are grouped into four classes of increasing severity: none (10-14), minimal nonproliferative diabetic retinopathy (NPDR) (15-39), moderate to severe NPDR (40-59), and proliferative diabetic retinopathy (60+). These four groups have also been dichotomized to none or minimal (10-39) and moderate to severe diabetic retinopathy (40+). RESULTS - The prevalence of diabetic retinopathy scores >40 was higher for Hispanics (36%) and African Americans (29%) than for non-Hispanic whites (22%). The difference between Hispanics and non-Hispanic whites was significant (P <0.05). Similarly, the prevalence of diabetic retinopathy scores >40 was significantly higher in African Americans than in non-Hispanic whites (P <0.05). These differences could not be accounted for by an imbalance in traditional risk factors such as age, duration of diagnosed diabetes, HbA1c (A1C), and blood pressure. Diabetic retinopathy seventy scores were also significantly associated with increasing years of disease duration, A1C, systolic and diastolic blood pressure, the degree of microalbuminuria, fibrinogen, and the percentage of patients with amputations. There was no relationship between retinopathy severity and the percentage of people who had strokes or cardiac revascularization procedures. There was an inverse relationship between retinopathy severity and total cholesterol, triglycerides, and plasminogen activator inhibitor-1 as well as with smoking history. Diabetic retinopathy scores were not associated with age. CONCLUSIONS - In addition to many well-known associations with retinopathy, a higher frequency of severe diabetic retinopathy was found in the Hispanic and African-American patients at entry into the VADT that is not accounted for by traditional risk factors for diabetic retinopathy, and these substantial ethnic differences remain to be explained.

AB - OBJECTIVE - The Veterans Affairs Diabetes Trial (VADT) cohort is enriched with ∼20% Hispanics and 20% African Americans, affording a unique opportunity to study ethnic differences in retinopathy. RESEARCH DESIGN AND METHODS - Cross-sectional analyses on the baseline seven-field stereo fundus photos of 1,283 patients are reported here. Diabetic retinopathy scores are grouped into four classes of increasing severity: none (10-14), minimal nonproliferative diabetic retinopathy (NPDR) (15-39), moderate to severe NPDR (40-59), and proliferative diabetic retinopathy (60+). These four groups have also been dichotomized to none or minimal (10-39) and moderate to severe diabetic retinopathy (40+). RESULTS - The prevalence of diabetic retinopathy scores >40 was higher for Hispanics (36%) and African Americans (29%) than for non-Hispanic whites (22%). The difference between Hispanics and non-Hispanic whites was significant (P <0.05). Similarly, the prevalence of diabetic retinopathy scores >40 was significantly higher in African Americans than in non-Hispanic whites (P <0.05). These differences could not be accounted for by an imbalance in traditional risk factors such as age, duration of diagnosed diabetes, HbA1c (A1C), and blood pressure. Diabetic retinopathy seventy scores were also significantly associated with increasing years of disease duration, A1C, systolic and diastolic blood pressure, the degree of microalbuminuria, fibrinogen, and the percentage of patients with amputations. There was no relationship between retinopathy severity and the percentage of people who had strokes or cardiac revascularization procedures. There was an inverse relationship between retinopathy severity and total cholesterol, triglycerides, and plasminogen activator inhibitor-1 as well as with smoking history. Diabetic retinopathy scores were not associated with age. CONCLUSIONS - In addition to many well-known associations with retinopathy, a higher frequency of severe diabetic retinopathy was found in the Hispanic and African-American patients at entry into the VADT that is not accounted for by traditional risk factors for diabetic retinopathy, and these substantial ethnic differences remain to be explained.

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