Diabetic retinopathy is a predictor of chronic respiratory failure: A nationwide register-based cohort study.

Content Provider	Europe PMC
Author	Thinggaard, Benjamin Sommer Stokholm, Lonny Davidsen, Jesper Rømhild Larsen, Maria Carius Möller, Sören Thykjær, Anne Suhr Andresen, Jens Lundgaard Andersen, Nis Heegaard, Steffen Højlund, Kurt Kawasaki, Ryo Laugesen, Caroline Bek, Toke Grauslund, Jakob
Copyright Year	2023
Abstract	PurposeDiabetic retinopathy (DR) is a hypoxic retinal disease, but so far, the association with systemic hypoxia is poorly understood. Hence, the aim of this study was to evaluate cross-sectional and longitudinal associations between DR and chronic respiratory failure (CRF) in a national cohort.DesignCross-sectional and 5-year longitudinal register-based cohort study.MethodsBetween 2013 and 2018, we included patients with diabetes from the Danish Registry of Diabetic Retinopathy, who were each age and sex matched with five controls without diabetes. At index date, the prevalence of CRF was compared between cases and controls, and the longitudinal relationship between DR and CRF was assessed in a five-year follow-up.ResultsAt baseline, we identified 1,980 and 9,990 patients with CRF among 205,970 cases and 1,003,170 controls. The prevalence of CRF was higher among cases than controls (OR 1.75, 95% CI 1.65–1.86), but no difference between cases with and without DR was found.During follow-up, we identified 1,726 and 5,177 events of CRF among cases and controls, respectively. The incidence of CRF was higher among both cases with and without DR compared to controls (DR level 0: HR 1.24, 95% CI 1.16–1.33, DR level 1–4: HR 1.86, 95% CI 1.63–2.12), and higher among cases with DR compared to cases without DR (HR 1.54, 95% CI 1.38–1.72).ConclusionIn this study based on nationwide data, we found an increased risk of present and incident CRF in patients with diabetes with or without DR, and we identified DR as a predictor of future CRF.
Journal	Heliyon
Volume Number	9
PubMed Central reference number	PMC10329134
Issue Number	6
PubMed reference number	37426795
e-ISSN	24058440
DOI	10.1016/j.heliyon.2023.e17342
Language	English
Publisher	Elsevier
Publisher Date	2023-06-19
Access Restriction	Open
Rights License	This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). © 2023 The Authors. Published by Elsevier Ltd.
Subject Keyword	Diabetic retinopathy Chronic respiratory failure Systemic hypoxia Diabetes mellitus Screening for diabetic retinopathy Epidemiology
Content Type	Text
Resource Type	Article
Subject	Multidisciplinary