Aspirin intake is not associated with diabetic retinopathy and diabetic macular edema: A report from the Fushun diabetic retinopathy cohort study

被引:0
作者
Lin, Wei [1 ]
Li, Dong [2 ]
Wen, Liang [2 ]
Moonasar, Nived [3 ]
Wang, Yu [2 ]
Lin, Zhong [1 ,4 ]
机构
[1] Wenzhou Med Univ, Eye Hosp, Natl Clin Res Ctr Ocular Dis, Wenzhou 325027, Peoples R China
[2] Fushun Eye Hosp, 1 Hu Po Quan St, Fushun 113006, Liaoning, Peoples R China
[3] Caribbean Eye Inst, Valsayn, Trinidad Tobago
[4] 270 Xueyuan West Rd, Wenzhou 325027, Zhejiang, Peoples R China
关键词
Aspirin intake; diabetic macular edema; diabetic retinopathy; prevalence; incidence; PREVALENCE; PROGRESSION; RISK;
D O I
10.4103/IJO.IJO_2932_23
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
Purpose: We aimed to study the effects of aspirin intake for diabetic retinopathy (DR) and diabetic macular edema (DME) in a cohort from northeastern China.Participants in the Fushun Diabetic Retinopathy Cohort Study were enrolled between July 2012 and May 2013. Fundus photographs of six fields were graded according to the modified Airlie House Classification system. The prevalence, incidence, progression, and regression of DR, as well as the prevalence/incidence of DME, were evaluated at baseline and during follow-up examinations after at least 1 year.In total, 1370 patients were enrolled in the study, and 270 (19.7%) were taking aspirin. The prevalence of any DR in participants with and without aspirin intake was 47.4% and 44.9%, respectively (P = 0.46). The incidence of any DR in patients with and without aspirin intake was 9.2% and 8.3%, respectively (P = 0.74). In univariate regression, there was no association between aspirin intake and the prevalence of any DR and DME (odds ratios (OR), 95% confidence intervals (CI): 0.93, 0.68-1.27 and 1.22, 0.79-1.88, respectively). Aspirin intake was not significantly associated with the prevalence and incidence of DME (OR, 95% CI: 1.22, 0.79-1.88 and 1.79, 0.62-5.17, respectively). Furthermore, aspirin intake was not significantly associated with DR progression or regression (OR, 95% CI: 1.04, 0.66-1.66 and 0.75, 0.52-1.09, respectively).Aspirin intake was not associated with the prevalence and incidence of any DR or DME in a northeastern Chinese population. Neither progression nor regression of DR revealed a significant association with aspirin intake.Diabetes mellitus (DM) is a global health issue, with the number of people with DM worldwide expected to reach 592 million by 2035.[1] The estimated standardized prevalence of total diagnosed and undiagnosed diabetes is 10.9% (more than 140 million) among the Chinese adult population.[2] A retrospective population-based study showed that the incidence rate is 4.65/1000 person-years in the Chinese population.[3,4] Diabetic retinopathy (DR) is a common complication of DM and the leading cause of vision loss globally.[5] The number of individuals with DR will reach 200 million by 2030.[6] Recently, we found that the prevalence of DR is 44.3% among people with DM in a population of northeastern China.[7]DM is characterized by hyperglycemia, which induces endothelial dysfunction, platelet hyperactivity, and a hypercoagulable state.[8,9] Therefore, the risk of thrombosis is higher in patients with DM than among individuals without DM.[10] Aspirin is used to prevent thrombotic complications in patients with DM.[11] A hypercoagulable state with endothelial damage can cause vascular occlusion, which may be related to DR.[12] Accordingly, aspirin intake may be a protective factor in patients with DR. The role of aspirin in DR has been studied previously, albeit with controversial findings, and most studies have been conducted among Western populations. The Early Treatment Diabetic Retinopathy Study (ETDRS), a randomized clinical trial that included 3711 patients, suggested that 650 mg/day use of aspirin has no beneficial effect on DR progression.[13] However, the Madrid Diabetes Study conducted in a European cohort reported that the use of aspirin was related with the increased incidence of DR.[14] Conversely, a multicenter randomized controlled clinical trial concluded that the progression of early DR was significantly slower in patients with aspirin use.[15]Whether aspirin intake affects DR development or its progression is still up for debate. Therefore, the objective of this study was to explore the association between aspirin intake and DR in a cohort from northeastern China.Purpose: We aimed to study the effects of aspirin intake for diabetic retinopathy (DR) and diabetic macular edema (DME) in a cohort from northeastern China.Participants in the Fushun Diabetic Retinopathy Cohort Study were enrolled between July 2012 and May 2013. Fundus photographs of six fields were graded according to the modified Airlie House Classification system. The prevalence, incidence, progression, and regression of DR, as well as the prevalence/incidence of DME, were evaluated at baseline and during follow-up examinations after at least 1 year.In total, 1370 patients were enrolled in the study, and 270 (19.7%) were taking aspirin. The prevalence of any DR in participants with and without aspirin intake was 47.4% and 44.9%, respectively (P = 0.46). The incidence of any DR in patients with and without aspirin intake was 9.2% and 8.3%, respectively (P = 0.74). In univariate regression, there was no association between aspirin intake and the prevalence of any DR and DME (odds ratios (OR), 95% confidence intervals (CI): 0.93, 0.68-1.27 and 1.22, 0.79-1.88, respectively). Aspirin intake was not significantly associated with the prevalence and incidence of DME (OR, 95% CI: 1.22, 0.79-1.88 and 1.79, 0.62-5.17, respectively). Furthermore, aspirin intake was not significantly associated with DR progression or regression (OR, 95% CI: 1.04, 0.66-1.66 and 0.75, 0.52-1.09, respectively).Aspirin intake was not associated with the prevalence and incidence of any DR or DME in a northeastern Chinese population. Neither progression nor regression of DR revealed a significant association with aspirin intake.Diabetes mellitus (DM) is a global health issue, with the number of people with DM worldwide expected to reach 592 million by 2035.[1] The estimated standardized prevalence of total diagnosed and undiagnosed diabetes is 10.9% (more than 140 million) among the Chinese adult population.[2] A retrospective population-based study showed that the incidence rate is 4.65/1000 person-years in the Chinese population.[3,4] Diabetic retinopathy (DR) is a common complication of DM and the leading cause of vision loss globally.[5] The number of individuals with DR will reach 200 million by 2030.[6] Recently, we found that the prevalence of DR is 44.3% among people with DM in a population of northeastern China.[7]DM is characterized by hyperglycemia, which induces endothelial dysfunction, platelet hyperactivity, and a hypercoagulable state.[8,9] Therefore, the risk of thrombosis is higher in patients with DM than among individuals without DM.[10] Aspirin is used to prevent thrombotic complications in patients with DM.[11] A hypercoagulable state with endothelial damage can cause vascular occlusion, which may be related to DR.[12] Accordingly, aspirin intake may be a protective factor in patients with DR. The role of aspirin in DR has been studied previously, albeit with controversial findings, and most studies have been conducted among Western populations. The Early Treatment Diabetic Retinopathy Study (ETDRS), a randomized clinical trial that included 3711 patients, suggested that 650 mg/day use of aspirin has no beneficial effect on DR progression.[13] However, the Madrid Diabetes Study conducted in a European cohort reported that the use of aspirin was related with the increased incidence of DR. [14] Conversely, a multicenter randomized controlled clinical trial concluded that the progression of early DR was significantly slower in patients with aspirin use.[15]Whether aspirin intake affects DR development or its progression is still up for debate. Therefore, the objective of this study was to explore the association between aspirin intake and DR in a cohort from northeastern China.Purpose: We aimed to study the effects of aspirin intake for diabetic retinopathy (DR) and diabetic macular edema (DME) in a cohort from northeastern China.Participants in the Fushun Diabetic Retinopathy Cohort Study were enrolled between July 2012 and May 2013. Fundus photographs of six fields were graded according to the modified Airlie House Classification system. The prevalence, incidence, progression, and regression of DR, as well as the prevalence/incidence of DME, were evaluated at baseline and during follow-up examinations after at least 1 year.In total, 1370 patients were enrolled in the study, and 270 (19.7%) were taking aspirin. The prevalence of any DR in participants with and without aspirin intake was 47.4% and 44.9%, respectively (P = 0.46). The incidence of any DR in patients with and without aspirin intake was 9.2% and 8.3%, respectively (P = 0.74). In univariate regression, there was no association between aspirin intake and the prevalence of any DR and DME (odds ratios (OR), 95% confidence intervals (CI): 0.93, 0.68-1.27 and 1.22, 0.79-1.88, respectively). Aspirin intake was not significantly associated with the prevalence and incidence of DME (OR, 95% CI: 1.22, 0.79-1.88 and 1.79, 0.62-5.17, respectively). Furthermore, aspirin intake was not significantly associated with DR progression or regression (OR, 95% CI: 1.04, 0.66-1.66 and 0.75, 0.52-1.09, respectively).Aspirin intake was not associated with the prevalence and incidence of any DR or DME in a northeastern Chinese population. Neither progression nor regression of DR revealed a significant association with aspirin intake.Diabetes mellitus (DM) is a global health issue, with the number of people with DM worldwide expected to reach 592 million by 2035.[1] The estimated standardized prevalence of total diagnosed and undiagnosed diabetes is 10.9% (more than 140 million) among the Chinese adult population.[2] A retrospective population-based study showed that the incidence rate is 4.65/1000 person-years in the Chinese population.[3,4] Diabetic retinopathy (DR) is a common complication of DM and the leading cause of vision loss globally.[5] The number of individuals with DR will reach 200 million by 2030.[6] Recently, we found that the prevalence of DR is 44.3% among people with DM in a population of northeastern China.[7]DM is characterized by hyperglycemia, which induces endothelial dysfunction, platelet hyperactivity, and a hypercoagulable state.[8,9] Therefore, the risk of thrombosis is higher in patients with DM than among individuals without DM.[10] Aspirin is used to prevent thrombotic complications in patients with DM.[11] A hypercoagulable state with endothelial damage can cause vascular occlusion, which may be related to DR.[12] Accordingly, aspirin intake may be a protective factor in patients with DR. The role of aspirin in DR has been studied previously, albeit with controversial findings, and most studies have been conducted among Western populations. The Early Treatment Diabetic Retinopathy Study (ETDRS), a randomized clinical trial that included 3711 patients, suggested that 650 mg/day use of aspirin has no beneficial effect on DR progression. [13] However, the Madrid Diabetes Study conducted in a European cohort reported that the use of aspirin was related with the increased incidence of DR.[14] Conversely, a multicenter randomized controlled clinical trial concluded that the progression of early DR was significantly slower in patients with aspirin use.[15]Whether aspirin intake affects DR development or its progression is still up for debate. Therefore, the objective of this study was to explore the association between aspirin intake and DR in a cohort from northeastern China.Purpose: We aimed to study the effects of aspirin intake for diabetic retinopathy (DR) and diabetic macular edema (DME) in a cohort from northeastern China.Participants in the Fushun Diabetic Retinopathy Cohort Study were enrolled between July 2012 and May 2013. Fundus photographs of six fields were graded according to the modified Airlie House Classification system. The prevalence, incidence, progression, and regression of DR, as well as the prevalence/incidence of DME, were evaluated at baseline and during follow-up examinations after at least 1 year.In total, 1370 patients were enrolled in the study, and 270 (19.7%) were taking aspirin. The prevalence of any DR in participants with and without aspirin intake was 47.4% and 44.9%, respectively (P = 0.46). The incidence of any DR in patients with and without aspirin intake was 9.2% and 8.3%, respectively (P = 0.74). In univariate regression, there was no association between aspirin intake and the prevalence of any DR and DME (odds ratios (OR), 95% confidence intervals (CI): 0.93, 0.68-1.27 and 1.22, 0.79-1.88, respectively). Aspirin intake was not significantly associated with the prevalence and incidence of DME (OR, 95% CI: 1.22, 0.79-1.88 and 1.79, 0.62-5.17, respectively). Furthermore, aspirin intake was not significantly associated with DR progression or regression (OR, 95% CI: 1.04, 0.66-1.66 and 0.75, 0.52-1.09, respectively).Aspirin intake was not associated with the prevalence and incidence of any DR or DME in a northeastern Chinese population. Neither progression nor regression of DR revealed a significant association with aspirin intake.Diabetes mellitus (DM) is a global health issue, with the number of people with DM worldwide expected to reach 592 million by 2035.[1] The estimated standardized prevalence of total diagnosed and undiagnosed diabetes is 10.9% (more than 140 million) among the Chinese adult population.[2] A retrospective population-based study showed that the incidence rate is 4.65/1000 person-years in the Chinese population.[3,4] Diabetic retinopathy (DR) is a common complication of DM and the leading cause of vision loss globally.[5] The number of individuals with DR will reach 200 million by 2030.[6] Recently, we found that the prevalence of DR is 44.3% among people with DM in a population of northeastern China.[7]DM is characterized by hyperglycemia, which induces endothelial dysfunction, platelet hyperactivity, and a hypercoagulable state.[8,9] Therefore, the risk of thrombosis is higher in patients with DM than among individuals without DM.[10] Aspirin is used to prevent thrombotic complications in patients with DM.[11] A hypercoagulable state with endothelial damage can cause vascular occlusion, which may be related to DR.[12] Accordingly, aspirin intake may be a protective factor in patients with DR. The role of aspirin in DR has been studied previously, albeit with controversial findings, and most studies have been conducted among Western populations. The Early Treatment Diabetic Retinopathy Study (ETDRS), a randomized clinical trial that included 3711 patients, suggested that 650 mg/day use of aspirin has no beneficial effect on DR progression.[13] However, the Madrid Diabetes Study conducted in a European cohort reported that the use of aspirin was related with the increased incidence of DR.[14] Conversely, a multicenter randomized controlled clinical trial concluded that the progression of early DR was significantly slower in patients with aspirin use.[15]Whether aspirin intake affects DR development or its progression is still up for debate. Therefore, the objective of this study was to explore the association between aspirin intake and DR in a cohort from northeastern China.Purpose: We aimed to study the effects of aspirin intake for diabetic retinopathy (DR) and diabetic macular edema (DME) in a cohort from northeastern China.Participants in the Fushun Diabetic Retinopathy Cohort Study were enrolled between July 2012 and May 2013. Fundus photographs of six fields were graded according to the modified Airlie House Classification system. The prevalence, incidence, progression, and regression of DR, as well as the prevalence/incidence of DME, were evaluated at baseline and during follow-up examinations after at least 1 year.In total, 1370 patients were enrolled in the study, and 270 (19.7%) were taking aspirin. The prevalence of any DR in participants with and without aspirin intake was 47.4% and 44.9%, respectively (P = 0.46). The incidence of any DR in patients with and without aspirin intake was 9.2% and 8.3%, respectively (P = 0.74). In univariate regression, there was no association between aspirin intake and the prevalence of any DR and DME (odds ratios (OR), 95% confidence intervals (CI): 0.93, 0.68-1.27 and 1.22, 0.79-1.88, respectively). Aspirin intake was not significantly associated with the prevalence and incidence of DME (OR, 95% CI: 1.22, 0.79-1.88 and 1.79, 0.62-5.17, respectively). Furthermore, aspirin intake was not significantly associated with DR progression or regression (OR, 95% CI: 1.04, 0.66-1.66 and 0.75, 0.52-1.09, respectively).Aspirin intake was not associated with the prevalence and incidence of any DR or DME in a northeastern Chinese population. Neither progression nor regression of DR revealed a significant association with aspirin intake.Diabetes mellitus (DM) is a global health issue, with the number of people with DM worldwide expected to reach 592 million by 2035.[1] The estimated standardized prevalence of total diagnosed and undiagnosed diabetes is 10.9% (more than 140 million) among the Chinese adult population.[2] A retrospective population-based study showed that the incidence rate is 4.65/1000 person-years in the Chinese population.[3,4] Diabetic retinopathy (DR) is a common complication of DM and the leading cause of vision loss globally.[5] The number of individuals with DR will reach 200 million by 2030.[6] Recently, we found that the prevalence of DR is 44.3% among people with DM in a population of northeastern China.[7]DM is characterized by hyperglycemia, which induces endothelial dysfunction, platelet hyperactivity, and a hypercoagulable state.[8,9] Therefore, the risk of thrombosis is higher in patients with DM than among individuals without DM.[10] Aspirin is used to prevent thrombotic complications in patients with DM.[11] A hypercoagulable state with endothelial damage can cause vascular occlusion, which may be related to DR.[12] Accordingly, aspirin intake may be a protective factor in patients with DR. The role of aspirin in DR has been studied previously, albeit with controversial findings, and most studies have been conducted among Western populations. The Early Treatment Diabetic Retinopathy Study (ETDRS), a randomized clinical trial that included 3711 patients, suggested that 650 mg/day use of aspirin has no beneficial effect on DR progression.[13] However, the Madrid Diabetes Study conducted in a European cohort reported that the use of aspirin was related with the increased incidence of DR.[14] Conversely, a multicenter randomized controlled clinical trial concluded that the progression of early DR was significantly slower in patients with aspirin use.[15]Whether aspirin intake affects DR development or its progression is still up for debate. Therefore, the objective of this study was to explore the association between aspirin intake and DR in a cohort from northeastern China.Purpose: We aimed to study the effects of aspirin intake for diabetic retinopathy (DR) and diabetic macular edema (DME) in a cohort from northeastern China.Participants in the Fushun Diabetic Retinopathy Cohort Study were enrolled between July 2012 and May 2013. Fundus photographs of six fields were graded according to the modified Airlie House Classification system. The prevalence, incidence, progression, and regression of DR, as well as the prevalence/incidence of DME, were evaluated at baseline and during follow-up examinations after at least 1 year.In total, 1370 patients were enrolled in the study, and 270 (19.7%) were taking aspirin. The prevalence of any DR in participants with and without aspirin intake was 47.4% and 44.9%, respectively (P = 0.46). The incidence of any DR in patients with and without aspirin intake was 9.2% and 8.3%, respectively (P = 0.74). In univariate regression, there was no association between aspirin intake and the prevalence of any DR and DME (odds ratios (OR), 95% confidence intervals (CI): 0.93, 0.68-1.27 and 1.22, 0.79-1.88, respectively). Aspirin intake was not significantly associated with the prevalence and incidence of DME (OR, 95% CI: 1.22, 0.79-1.88 and 1.79, 0.62-5.17, respectively). Furthermore, aspirin intake was not significantly associated with DR progression or regression (OR, 95% CI: 1.04, 0.66-1.66 and 0.75, 0.52-1.09, respectively).Aspirin intake was not associated with the prevalence and incidence of any DR or DME in a northeastern Chinese population. Neither progression nor regression of DR revealed a significant association with aspirin intake.Diabetes mellitus (DM) is a global health issue, with the number of people with DM worldwide expected to reach 592 million by 2035.[1] The estimated standardized prevalence of total diagnosed and undiagnosed diabetes is 10.9% (more than 140 million) among the Chinese adult population.[2] A retrospective population-based study showed that the incidence rate is 4.65/1000 person-years in the Chinese population.[3,4] Diabetic retinopathy (DR) is a common complication of DM and the leading cause of vision loss globally.[5] The number of individuals with DR will reach 200 million by 2030.[6] Recently, we found that the prevalence of DR is 44.3% among people with DM in a population of northeastern China.[7]DM is characterized by hyperglycemia, which induces endothelial dysfunction, platelet hyperactivity, and a hypercoagulable state.[8,9] Therefore, the risk of thrombosis is higher in patients with DM than among individuals without DM.[10] Aspirin is used to prevent thrombotic complications in patients with DM. [11] A hypercoagulable state with endothelial damage can cause vascular occlusion, which may be related to DR.[12] Accordingly, aspirin intake may be a protective factor in patients with DR. The role of aspirin in DR has been studied previously, albeit with controversial findings, and most studies have been conducted among Western populations. The Early Treatment Diabetic Retinopathy Study (ETDRS), a randomized clinical trial that included 3711 patients, suggested that 650 mg/day use of aspirin has no beneficial effect on DR progression.[13] However, the Madrid Diabetes Study conducted in a European cohort reported that the use of aspirin was related with the increased incidence of DR.[14] Conversely, a multicenter randomized controlled clinical trial concluded that the progression of early DR was significantly slower in patients with aspirin use.[15]Whether aspirin intake affects DR development or its progression is still up for debate. Therefore, the objective of this study was to explore the association between aspirin intake and DR in a cohort from northeastern China.Purpose: We aimed to study the effects of aspirin intake for diabetic retinopathy (DR) and diabetic macular edema (DME) in a cohort from northeastern China.Participants in the Fushun Diabetic Retinopathy Cohort Study were enrolled between July 2012 and May 2013. Fundus photographs of six fields were graded according to the modified Airlie House Classification system. The prevalence, incidence, progression, and regression of DR, as well as the prevalence/incidence of DME, were evaluated at baseline and during follow-up examinations after at least 1 year.In total, 1370 patients were enrolled in the study, and 270 (19.7%) were taking aspirin. The prevalence of any DR in participants with and without aspirin intake was 47.4% and 44.9%, respectively (P = 0.46). The incidence of any DR in patients with and without aspirin intake was 9.2% and 8.3%, respectively (P = 0.74). In univariate regression, there was no association between aspirin intake and the prevalence of any DR and DME (odds ratios (OR), 95% confidence intervals (CI): 0.93, 0.68-1.27 and 1.22, 0.79-1.88, respectively). Aspirin intake was not significantly associated with the prevalence and incidence of DME (OR, 95% CI: 1.22, 0.79-1.88 and 1.79, 0.62-5.17, respectively). Furthermore, aspirin intake was not significantly associated with DR progression or regression (OR, 95% CI: 1.04, 0.66-1.66 and 0.75, 0.52-1.09, respectively).Aspirin intake was not associated with the prevalence and incidence of any DR or DME in a northeastern Chinese population. Neither progression nor regression of DR revealed a significant association with aspirin intake.Diabetes mellitus (DM) is a global health issue, with the number of people with DM worldwide expected to reach 592 million by 2035.[1] The estimated standardized prevalence of total diagnosed and undiagnosed diabetes is 10.9% (more than 140 million) among the Chinese adult population.[2] A retrospective population-based study showed that the incidence rate is 4.65/1000 person-years in the Chinese population.[3,4] Diabetic retinopathy (DR) is a common complication of DM and the leading cause of vision loss globally.[5] The number of individuals with DR will reach 200 million by 2030.[6] Recently, we found that the prevalence of DR is 44.3% among people with DM in a population of northeastern China.[7]DM is characterized by hyperglycemia, which induces endothelial dysfunction, platelet hyperactivity, and a hypercoagulable state. [8,9] Therefore, the risk of thrombosis is higher in patients with DM than among individuals without DM.[10] Aspirin is used to prevent thrombotic complications in patients with DM.[11] A hypercoagulable state with endothelial damage can cause vascular occlusion, which may be related to DR.[12] Accordingly, aspirin intake may be a protective factor in patients with DR. The role of aspirin in DR has been studied previously, albeit with controversial findings, and most studies have been conducted among Western populations. The Early Treatment Diabetic Retinopathy Study (ETDRS), a randomized clinical trial that included 3711 patients, suggested that 650 mg/day use of aspirin has no beneficial effect on DR progression.[13] However, the Madrid Diabetes Study conducted in a European cohort reported that the use of aspirin was related with the increased incidence of DR.[14] Conversely, a multicenter randomized controlled clinical trial concluded that the progression of early DR was significantly slower in patients with aspirin use.[15]Whether aspirin intake affects DR development or its progression is still up for debate. Therefore, the objective of this study was to explore the association between aspirin intake and DR in a cohort from northeastern China.
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