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Retinal image measurements and their association with chronic kidney disease in Chinese patients with type 2 diabetes: the NCD study

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Abstract

Aims

Retinal and renal microcirculations are known to share similar physiological changes during early diabetes because of abnormal glucose metabolism and other processes. The retinal vasculature therefore may serve as potential biomarker for the early identification of those at high risk of chronic kidney disease (CKD) in diabetes.

Methods

Data from 1925 patients (aged 49.0 ± 10.3) with type 2 diabetes were analyzed. Various retinal image measurements (RIMs) were collected using a validated fully automated computer program. Multiple logistic regressions were performed to investigate the correlation between RIMs and CKD.

Results

In logistic regression adjusting for multiple variables, wider venular calibers in the central and middle zones and narrower arteriolar caliber in the central zone were associated with CKD (p < 0.001, p = 0.020, and p < 0.001, respectively). Increased arteriolar tortuosity was associated with CKD (p = 0.035). Multiple image texture measurements were also significantly associated with CKD.

Conclusions

Renal dysfunction in type 2 diabetes was associated with various retinal image measurements. These non-invasive image measurements may serve as potential biomarkers for the early identification and monitoring of individuals at high risk of CKD in the course of diabetes.

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Availability of data and materials

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

CKD:

Chronic kidney disease

CRAE:

Central retinal arteriolar equivalent

CRVE:

Central retinal venular equivalent

DD:

Disk diameter

DM:

Diabetes mellitus

eGFR:

Estimated glomerular filtration rate

GLCM:

Gray-level co-occurrence matrix

HDL:

High-density lipoprotein

LDL:

Low-density lipoprotein

NCD:

Northwestern China Diabetes

RIM:

Retinal image measurement

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Funding

This work was financially supported by Shaanxi National Science Foundation (2020JQ-071), National Natural Science Foundation of China (81401480), Top talent fund of Tangdu Hospital and Innovation fund of Tangdu Hospital.

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Author notes

  1. Xiayu Xu and Bin Gao are contributed equally.

Authors and Affiliations

  1. The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi’an Jiaotong University, Xi’an, 710049, People’s Republic of China

    Xiayu Xu, Wenxiang Ding & Feng Xu

  2. Bioinspired Engineering and Biomechanics Center (BEBC), Xi’an Jiaotong University, Xi’an, 710049, People’s Republic of China

    Xiayu Xu, Wenxiang Ding & Feng Xu

  3. Department of Endocrinology, Tangdu Hospital Air Force Military Medical University, Xi’an, 710038, People’s Republic of China

    Bin Gao

  4. Department of Endocrinology and Metabolism, Xijing Hospital, Air Force Military Medical University, Xi’an, 710032, People’s Republic of China

    Qiong Wang, Maiye Zhang, Fei Sun & Qiuhe Ji

  5. Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands

    Tao Tan

  6. Department of Ophthalmology, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061, People’s Republic of China

    Jianqin Lei

Authors
  1. Xiayu Xu
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  2. Bin Gao
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Contributions

XX and BG designed the study and interpreted the results. XX, BG, and FX wrote the manuscript. WD analyzed the images and performed statistical analysis. BG, MZ, QW, and QJ collected the clinical data. QJ supervised the data quality control and statistical analysis. JL, TT, and FS contributed to the discussion and edited the manuscript. XX and BG had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Corresponding authors

Correspondence to Qiuhe Ji or Feng Xu.

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Conflict of interest

No potential conflicts of interests relevant to this article were reported.

Ethics approval and consent to participate

All data were collected with approval by the Institutional Review Board of Chinese Air Force Medical University in accordance with the tenets of the Declaration of Helsinki. Informed consent was obtained from all participants.

Informed consent

Written informed consent was obtained from all participants.

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This article belongs to the topical collection Diabetic Nephropathy, managed by Giuseppe Pugliese.

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Xu, X., Gao, B., Ding, W. et al. Retinal image measurements and their association with chronic kidney disease in Chinese patients with type 2 diabetes: the NCD study. Acta Diabetol 58, 363–370 (2021). https://doi.org/10.1007/s00592-020-01621-6

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  • DOI: https://doi.org/10.1007/s00592-020-01621-6

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