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ORIGINAL RESEARCH article

Front. Endocrinol.
Sec. Clinical Diabetes
Volume 15 - 2024 | doi: 10.3389/fendo.2024.1420948
This article is part of the Research Topic Continuous Glucose Monitoring: Beyond Diabetes Management View all 6 articles

Risk prediction of diabetic retinopathy based on visit-to-visit fasting blood glucose indices

Provisionally accepted
Ying Ju Ying Ju *Zhengyang Guo Zhengyang Guo *Jiaqi Ai Jiaqi Ai *Kai Yang Kai Yang *Xiaoxuan Zhu Xiaoxuan Zhu *Keai Shi Keai Shi *Chunmei Li Chunmei Li *Tianyun Yu Tianyun Yu *Yunfan Xiao Yunfan Xiao *Binbin Su Binbin Su *Jinxia Yan Jinxia Yan *Ziyu Li Ziyu Li *Wei Lian Wei Lian *Zhenqin Wang Zhenqin Wang *Shasha Ding Shasha Ding *Yudie Wang Yudie Wang *Fan Lu Fan Lu *Lele Cui Lele Cui *Ming Li Ming Li *
  • Wenzhou Medical University Eye Hospital, Wenzhou, Zhejiang Province, China

The final, formatted version of the article will be published soon.

    Objective: The long-term glucose monitoring is essential to the risk assessment of diabetic retinopathy (DR), the aim of this study was to investigate the predictive ability of visit-to-visit fasting blood glucose (FBG) indices on the risk of DR. Methods: This was a community-based, cohort study conducted from 2013 to 2021. DR was diagnosed by digital fundus photography. The FPG indices included FBG, var. Associations of each FBG indices and DR were estimated using multinomial logistic regression models adjusting for confounders, and discrimination was determined by area under the curve (AUC). Predictive utility of different models was compared by changes in AUC, integrated discrimination improvement (IDI), and net reclassification index (NRI). Results: This study analyzed 5054 participants, the mean age was 46.26 ± 11.44 years, and 2620 (51.84%) were women. After adjustment for confounders, the adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for FBG, SD, CV, VIM, ARV, M-FBG, and cumulative FBG load were 1.62 (1.52—1.73), 2.74 (2.38—3.16), 1.78 (1.62—1.95), 1.11 (0.95—1.29), 1.72 (1.56—1.91), 2.15 (1.96—2.36), and 2.57 (2.31—2.85), respectively. The AUC of the model with separate cumulative FBG load and classical risk factors was 0.9135 (95%CI 0.8890—0.9380), and no substantive improvement in discrimination was achieved with the addition of other FBG indices once cumulative FBG load was in the model. Conclusions: Cumulative FBG load is adequate for capturing the glucose-related DR risk, and the predictive utility of cumulative FBG load is not significantly improved by adding or replacing other FBG indices in the assessment of DR risk.

    Keywords: FBG index, risk prediction, Diabetic Retinopathy, cohort study, Diabetic microvascular complication

    Received: 21 Apr 2024; Accepted: 26 Aug 2024.

    Copyright: © 2024 Ju, Guo, Ai, Yang, Zhu, Shi, Li, Yu, Xiao, Su, Yan, Li, Lian, Wang, Ding, Wang, Lu, Cui and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Ying Ju, Wenzhou Medical University Eye Hospital, Wenzhou, Zhejiang Province, China
    Zhengyang Guo, Wenzhou Medical University Eye Hospital, Wenzhou, Zhejiang Province, China
    Jiaqi Ai, Wenzhou Medical University Eye Hospital, Wenzhou, Zhejiang Province, China
    Kai Yang, Wenzhou Medical University Eye Hospital, Wenzhou, Zhejiang Province, China
    Xiaoxuan Zhu, Wenzhou Medical University Eye Hospital, Wenzhou, Zhejiang Province, China
    Keai Shi, Wenzhou Medical University Eye Hospital, Wenzhou, Zhejiang Province, China
    Chunmei Li, Wenzhou Medical University Eye Hospital, Wenzhou, Zhejiang Province, China
    Tianyun Yu, Wenzhou Medical University Eye Hospital, Wenzhou, Zhejiang Province, China
    Yunfan Xiao, Wenzhou Medical University Eye Hospital, Wenzhou, Zhejiang Province, China
    Binbin Su, Wenzhou Medical University Eye Hospital, Wenzhou, Zhejiang Province, China
    Jinxia Yan, Wenzhou Medical University Eye Hospital, Wenzhou, Zhejiang Province, China
    Ziyu Li, Wenzhou Medical University Eye Hospital, Wenzhou, Zhejiang Province, China
    Wei Lian, Wenzhou Medical University Eye Hospital, Wenzhou, Zhejiang Province, China
    Zhenqin Wang, Wenzhou Medical University Eye Hospital, Wenzhou, Zhejiang Province, China
    Shasha Ding, Wenzhou Medical University Eye Hospital, Wenzhou, Zhejiang Province, China
    Yudie Wang, Wenzhou Medical University Eye Hospital, Wenzhou, Zhejiang Province, China
    Fan Lu, Wenzhou Medical University Eye Hospital, Wenzhou, Zhejiang Province, China
    Lele Cui, Wenzhou Medical University Eye Hospital, Wenzhou, Zhejiang Province, China
    Ming Li, Wenzhou Medical University Eye Hospital, Wenzhou, Zhejiang Province, China

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