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Sci Rep. 2017 Sep 18;7(1):11757. doi: 10.1038/s41598-017-11906-6.

Normal-to-mildly increased albuminuria predicts the risk for diabetic retinopathy in patients with type 2 diabetes.

Author information

1
Division of Endocrinology and Metabolism, Department of Internal Medicine, Myongji Hospital, Seonam University College of Medicine, Gyeonggi-do, Republic of Korea.
2
Department of Medical Statistics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
3
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
4
Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
5
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. drkwon@catholic.ac.kr.
6
Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. drkwon@catholic.ac.kr.

Abstract

Albuminuria is closely associated with diabetic retinopathy (DR), but the precise role of the albumin-to-creatinine ratio (ACR) in screening for DR remains to be determined. This study aimed to investigate an ACR threshold for predicting DR in patients with type 2 diabetes. A cross-sectional study was conducted on 1,102 type 2 diabetes patients, aged ≥30 years and recruited from the Korea National Health and Nutrition Examination Survey, 2010-2011. Participants were grouped by stage of DR: mild-to-moderate nonproliferative DR (NPDR), severe NPDR, and proliferative diabetic retinopathy (PDR). An early morning spot urine sample was obtained for ACR measurement. ROC curve analysis revealed that the optimal cut-off value of ACR for predicting DR was 2.26 mg/mmol (20 μg/mg). The prevalence of ACR ≥ 2.26 mg/mmol tended to increase with severity of DR. The risk for DR in patients with ACR ≥ 2.26 mg/mmol was higher than in those with ACR < 2.26 mg/mmol. The risk for severe NPDR and PDR also increased at ACR ≥ 2.26 mg/mmol. Normal-to-mildly increased albuminuria (an ACR of 2.26 mg/mmol) may predict the risk for DR development and progression in patients with type 2 diabetes.

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