Dissecting the relationship between heart failure and diabetic retinopathy severity in patients with diabetes and chronic kidney disease: an observational cohort study
Abstract Diabetic retinopathy (DR) is associated with increased cardiovascular risk, but evidence of its relationship with heart failure (HF) in people with diabetes and chronic kidney disease (CKD) is limited. Therefore, we examined the association between DR severity and concurrent HF status, as w...
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Nature Portfolio
2025-07-01
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| Online Access: | https://doi.org/10.1038/s41598-025-04523-1 |
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| author | Yi-Chen Huang Feng-Ching Shen Pei-Kang Liu Wei-Chun Su Teng-Hui Huang Ming-Yen Lin Mei-Chuan Kuo Yi-Wen Chiu Shang-Jyh Hwang Yi-Ting Lin Ping-Hsun Wu |
| author_facet | Yi-Chen Huang Feng-Ching Shen Pei-Kang Liu Wei-Chun Su Teng-Hui Huang Ming-Yen Lin Mei-Chuan Kuo Yi-Wen Chiu Shang-Jyh Hwang Yi-Ting Lin Ping-Hsun Wu |
| author_sort | Yi-Chen Huang |
| collection | DOAJ |
| description | Abstract Diabetic retinopathy (DR) is associated with increased cardiovascular risk, but evidence of its relationship with heart failure (HF) in people with diabetes and chronic kidney disease (CKD) is limited. Therefore, we examined the association between DR severity and concurrent HF status, as well as the risk of subsequent HF hospitalization in this population. A total of 1,503 patients with both diabetes and CKD underwent fundus photography. DR severity was classified into three groups: Group 1 (no apparent DR, mild non-proliferative DR [NPDR], moderate NPDR), group 2 (severe NPDR, very severe NPDR), and group 3 (proliferative DR [PDR], and high-risk PDR). Associations between HF status and DR severity were analyzed using ordinal regression. Cox proportional hazard models examined the association between DR severity and subsequent HF hospitalization. HF was positively associated with worse DR grade (adjusted odds ratio 2.09, 95% confidence interval [CI] 1.37–3.18). In patients without HF at baseline, a higher incidence of acute HF hospitalization over 5 years was identified in group 2 (hazard ratio 1.37, 95% CI 0.83–2.26) and group 3 (hazard ratio 1.86, 95% CI 1.22–2.83) compared to patients with less severe DR. In summary, DR severity is independently associated with both concurrent HF and risks for HF hospitalization over 5 years among those with diabetes and CKD and could aid cardiovascular risk stratification. |
| format | Article |
| id | doaj-art-51a75adb83c24396a3005ab694c0b9ab |
| institution | DOAJ |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Nature Portfolio |
| record_format | Article |
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| spelling | doaj-art-51a75adb83c24396a3005ab694c0b9ab2025-08-20T03:04:38ZengNature PortfolioScientific Reports2045-23222025-07-0115111110.1038/s41598-025-04523-1Dissecting the relationship between heart failure and diabetic retinopathy severity in patients with diabetes and chronic kidney disease: an observational cohort studyYi-Chen Huang0Feng-Ching Shen1Pei-Kang Liu2Wei-Chun Su3Teng-Hui Huang4Ming-Yen Lin5Mei-Chuan Kuo6Yi-Wen Chiu7Shang-Jyh Hwang8Yi-Ting Lin9Ping-Hsun Wu10Department of Ophthalmology, Kaohsiung Medical University Hospital Kaohsiung Medical UniversityDivision of Nephrology Department of Internal Medicine, Kaohsiung Medical University Hospital Kaohsiung Medical UniversityDepartment of Ophthalmology, Kaohsiung Medical University Hospital Kaohsiung Medical UniversityDepartment of General Medicine, Kaohsiung Medical University Hospital Kaohsiung Medical UniversityDivision of Nephrology Department of Internal Medicine, Kaohsiung Medical University Hospital Kaohsiung Medical UniversityDivision of Nephrology Department of Internal Medicine, Kaohsiung Medical University Hospital Kaohsiung Medical UniversityDivision of Nephrology Department of Internal Medicine, Kaohsiung Medical University Hospital Kaohsiung Medical UniversityDivision of Nephrology Department of Internal Medicine, Kaohsiung Medical University Hospital Kaohsiung Medical UniversityDivision of Nephrology Department of Internal Medicine, Kaohsiung Medical University Hospital Kaohsiung Medical UniversityFaculty of Medicine College of Medicine, Kaohsiung Medical UniversityDivision of Nephrology Department of Internal Medicine, Kaohsiung Medical University Hospital Kaohsiung Medical UniversityAbstract Diabetic retinopathy (DR) is associated with increased cardiovascular risk, but evidence of its relationship with heart failure (HF) in people with diabetes and chronic kidney disease (CKD) is limited. Therefore, we examined the association between DR severity and concurrent HF status, as well as the risk of subsequent HF hospitalization in this population. A total of 1,503 patients with both diabetes and CKD underwent fundus photography. DR severity was classified into three groups: Group 1 (no apparent DR, mild non-proliferative DR [NPDR], moderate NPDR), group 2 (severe NPDR, very severe NPDR), and group 3 (proliferative DR [PDR], and high-risk PDR). Associations between HF status and DR severity were analyzed using ordinal regression. Cox proportional hazard models examined the association between DR severity and subsequent HF hospitalization. HF was positively associated with worse DR grade (adjusted odds ratio 2.09, 95% confidence interval [CI] 1.37–3.18). In patients without HF at baseline, a higher incidence of acute HF hospitalization over 5 years was identified in group 2 (hazard ratio 1.37, 95% CI 0.83–2.26) and group 3 (hazard ratio 1.86, 95% CI 1.22–2.83) compared to patients with less severe DR. In summary, DR severity is independently associated with both concurrent HF and risks for HF hospitalization over 5 years among those with diabetes and CKD and could aid cardiovascular risk stratification.https://doi.org/10.1038/s41598-025-04523-1Heart failureDiabetic retinopathyChronic kidney diseaseDiabetes mellitus |
| spellingShingle | Yi-Chen Huang Feng-Ching Shen Pei-Kang Liu Wei-Chun Su Teng-Hui Huang Ming-Yen Lin Mei-Chuan Kuo Yi-Wen Chiu Shang-Jyh Hwang Yi-Ting Lin Ping-Hsun Wu Dissecting the relationship between heart failure and diabetic retinopathy severity in patients with diabetes and chronic kidney disease: an observational cohort study Scientific Reports Heart failure Diabetic retinopathy Chronic kidney disease Diabetes mellitus |
| title | Dissecting the relationship between heart failure and diabetic retinopathy severity in patients with diabetes and chronic kidney disease: an observational cohort study |
| title_full | Dissecting the relationship between heart failure and diabetic retinopathy severity in patients with diabetes and chronic kidney disease: an observational cohort study |
| title_fullStr | Dissecting the relationship between heart failure and diabetic retinopathy severity in patients with diabetes and chronic kidney disease: an observational cohort study |
| title_full_unstemmed | Dissecting the relationship between heart failure and diabetic retinopathy severity in patients with diabetes and chronic kidney disease: an observational cohort study |
| title_short | Dissecting the relationship between heart failure and diabetic retinopathy severity in patients with diabetes and chronic kidney disease: an observational cohort study |
| title_sort | dissecting the relationship between heart failure and diabetic retinopathy severity in patients with diabetes and chronic kidney disease an observational cohort study |
| topic | Heart failure Diabetic retinopathy Chronic kidney disease Diabetes mellitus |
| url | https://doi.org/10.1038/s41598-025-04523-1 |
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