We propose a study of age, sex and duration matched long-term diabetics (15 years or more), some of whom gave no evidence of diabetic retinopathy (controls), others with proliferative diabetic retinopathy (cases), in regard to the distribution of selected demographic systemic and ocular factors to determine if the distribution of any one particular, or any several of these factors, when taken independently or together is sufficiently different between the two groups to be considered a risk factor(s) or a protective factor(s) in the development of diabetic retinopathy. Patients will have an interview during which questions about medical and social factors possibly associated with the development of diabetic retinopathy will be asked. Patients will also have a standard eye examination, with stereo fundus photographs of seven standard fields taken to be used for classification of retinopathy. Those patients without visible retinopathy will have fluorescein angiography performed according to a standard protocol. Blood specimens will be drawn for analysis to evaluate systemic and metabolic factors that may play a role in the development of diabetic retinopathy. After all patients have been examined, photographed, interviewed, and had their laboratory evaluation, the data will be analyzed and estimations of relative odds for each individual variable studied will be computed. In addition, it is planned to look at combinations of variables as risk factors and to develop a multivariate risk function analysis of selected variables. Patients free of retinopathy (controls), will be followed prospectively at yearly intervals to evaluate the predictive value of the risk factors identified.

Agency
National Institute of Health (NIH)
Institute
National Eye Institute (NEI)
Type
Research Project (R01)
Project #
5R01EY002636-08
Application #
3256947
Study Section
(VID)
Project Start
1978-09-01
Project End
1987-08-31
Budget Start
1985-09-01
Budget End
1986-08-31
Support Year
8
Fiscal Year
1985
Total Cost
Indirect Cost
Name
Joslin Diabetes Center
Department
Type
DUNS #
071723084
City
Boston
State
MA
Country
United States
Zip Code
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Krolewski, A S; Barzilay, J; Warram, J H et al. (1992) Risk of early-onset proliferative retinopathy in IDDM is closely related to cardiovascular autonomic neuropathy. Diabetes 41:430-7
Janka, H U; Warram, J H; Rand, L I et al. (1989) Risk factors for progression of background retinopathy in long-standing IDDM. Diabetes 38:460-4
Krolewski, A S; Canessa, M; Warram, J H et al. (1988) Predisposition to hypertension and susceptibility to renal disease in insulin-dependent diabetes mellitus. N Engl J Med 318:140-5
Wulsin, L R; Jacobson, A M; Rand, L I (1987) Psychosocial aspects of diabetic retinopathy. Diabetes Care 10:367-73
Baker, R S; Rand, L I; Krolewski, A S et al. (1986) Influence of HLA-DR phenotype and myopia on the risk of nonproliferative and proliferative diabetic retinopathy. Am J Ophthalmol 102:693-700
Krolewski, A S; Warram, J H; Rand, L I et al. (1986) Risk of proliferative diabetic retinopathy in juvenile-onset type I diabetes: a 40-yr follow-up study. Diabetes Care 9:443-52
Starkman, H S; Gleason, R E; Rand, L I et al. (1986) Limited joint mobility (LJM) of the hand in patients with diabetes mellitus: relation to chronic complications. Ann Rheum Dis 45:130-5
Jacobson, A M; Rand, L I; Hauser, S T (1985) Psychologic stress and glycemic control: a comparison of patients with and without proliferative diabetic retinopathy. Psychosom Med 47:372-81
Rand, L I; Krolewski, A S; Aiello, L M et al. (1985) Multiple factors in the prediction of risk of proliferative diabetic retinopathy. N Engl J Med 313:1433-8