To investigate whether there is familial aggregation of diabetic retinopathy (DR) among type 2 diabetes mellitus (T2DM) patients in Chongqing, the municipality in southwest China.
Methods
From December 2004 to December 2006, 167 T2DM families with at least 2 diabetic siblings were investigated. In all 414 subjects, the sibling with the longest duration of diabetes was defined as the proband. The occurrence of retinopathy was compared between the siblings of probands with and without retinopathy. DR risk factors of the siblings of probands were studied by multiple logistic regression analysis.
Results
DR was diagnosed in 7.1% of the siblings of the probands without DR and in 29.7% of the siblings of the probands with DR. The difference reached statistical significance in probands with DR and probands without DR (p<0.0001). Nonesterified fatty acid (NEFA) was a risk factor for DR (odds ratio = 2.108, 95% confidence interval 1.077–4.127). It appeared that regardless of probands with DR, siblings with history of smoking had less risk for developing DR than those with no history of smoking.
Conclusions
Familial clustering of DR existed in the patients with T2DM in Chongqing, China. In DR siblings, NEFA is a risk factor of DR, while smoking may reduce DR occurrence.
VarmaR., MaciasG.L., TorresM.Biologic risk factors associated with diabetic retinopathy: the Los Angeles Latino Eye Study. Ophthalmology2007; 114: 1332–40.
2.
ZimmetP., AlbertiK., ShawJ.Global and societal implications of the diabetes epidemic. Nature2001; 414: 782–7.
DowseG.K., HumphreyA.R., CollinsV.R.Prevalence and risk factors for diabetic retinopathy in the multiethnic population of Mauritius. Am J Epidemiol1998; 147: 448–57.
KleinR., KleinB.E., MossS.E., DavisM.D., DeMetsD.L.The Wisconsin Epidemiologic Study of Diabetic Retinopathy: VII. Diabetic nonproliferative retinal lesions. Ophthalmology1987; 94: 1389–400.
7.
KleinR., KleinB.E., MossS.E., DavisM.D., DeMetsD.L.The Wisconsin Epidemiologic Study of Diabetic Retinopathy: IV. Diabetic macular edema. Ophthalmology1984; 91: 1464–74.
8.
KleinR., KleinB.E., MossS.E., DavisM.D., DeMetsD.L.Glycosylated hemoglobin predicts the incidence and progression of diabetic retinopathy. JAMA1988; 260: 2864–71.
9.
KleinR., KleinB.E., MossS.E., CruickshanksK.J.Relationship of hyperglycemia to the long-term incidence and progression of diabetic retinopathy. Arch Intern Med1994; 154: 2169–78.
10.
MonsonJ.P., KoiosG., TomsG.C.Relationship between retinopathy and glycemic control in insulin-dependent and non-insulin-dependent diabetes. J R Soc Med1986; 79: 274–6.
11.
UK Prospective Diabetes Study (UKPDS) Group.Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet1998; 352: 837–53.
12.
StrattonI.M., KohnerE.M., AldingtonS.J.UKPDS 50: Risk factors for incidence and progression of retinopathy in type II diabetes over 6 years from diagnosis. Diabetologia2001; 44: 156–63.
13.
GuillausseauP.J., MassinP., CharlesM.A.Glycaemic control and development of retinopathy in type 2 diabetes mellitus: a longitudinal study. Diabet Med1998; 15: 151–5.
LeslieR.D., PykeD.A.Diabetic retinopathy in identical twins. Diabetes1982; 31: 19–21.
16.
LindholmE., BakhtadzeE., CilioC., AgardhE., GroopL., AgardhC.D.Association between LTA, TNF and AGER polymorphisms and late diabetic complications. PLoS One2008; 3: e2546.
17.
BrucklacherR.M., PatelK.M., VanGuilderH.D.Whole genome assessment of the retinal response to diabetes reveals a progressive neurovascular inflammatory response. BMC Med Genomics2008; 1: 26.
18.
DemirciH., YurtcuE., ErgunM.A., YaziciA.C., KarasuC., YetkinI.Calpain 10 SNP-44 gene polymorphism affects susceptibility to type 2 diabetes mellitus and diabetic-related conditions. Genet Test2008; 12: 305–9.
19.
LiH., LoueyJ.W., ChoyK.W.EDN1 Lys198Asn is associated with diabetic retinopathy in type 2 diabetes. Mol Vis2008; 14: 1698–704.
20.
RemaM., SaravananG., DeepaR., MohanV.Familial clustering of diabetic retinopathy in South Indian type 2 diabetic patients. Diabet Med2002; 19: 910–6.
21.
Diabetes Control and Complications Trial Research Group.Clustering of long-term complications in families with diabetes in the Diabetes Control and Complications Trial. Diabetes1997; 46: 1829–39.
22.
HallmanD.M., HuberJ.C.Jr., GonzalezV.H., KleinB.E., KleinR., HanisC.L.Familial aggregation of severity of diabetic retinopathy in Mexican Americans from Starr County, Texas. Diabetes Care2005; 28: 1163–8.
23.
ImperatoreG., HansonR.L., PettittD.J., KobesS., BennettP.H., KnowlerW.C.Sib-pair linkage analysis for susceptibility genes for microvascular complications among Pima Indians with type 2 diabetes: Pima Diabetes Genes Group. Diabetes1998; 47: 821–30.
24.
WarpehaK.M., ChakravarthyU.Molecular genetics of microvascular disease in diabetic retinopathy. Eye2003; 17: 305–11.
25.
HallmanD.M., BoerwinkleE., GonzalezV.H., KleinB.E., KleinR., HanisC.L.A.Genome-Wide linkage scan for diabetic retinopathy susceptibility genes in Mexican Americans with type 2 diabetes from Starr County, Texas. Diabetes2007; 56: 1167–73.
26.
American Diabetes Association.Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care1997; 20: 1183–97.
27.
WilkinsonC.P., FerrisFLIII, KleinR.E.Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales. Ophthalmology2003; 110: 1677–82.
28.
YamamotoM., EgusaG., OkuboM., YamakidoM.Dissociation of microangiopathy and macroangiopathy in patients with Type 2 diabetes. Diabetes Care1998; 21: 1451–4.
29.
ChanJ.C., HawkinsB.R., CockramC.S.A Chinese family with non-insulin-dependent diabetes of early onset and severe diabetic complications. Diabetes Med1990; 7: 211–4.
Committee on Diabetic Twins Japan Diabetes Society.Diabetes mellitus in twins: a cooperative study in Japan. Diabetes Res Clin Pract1988; 5: 271–80.
32.
HietalaK., ForsblomC., SummanenP., GroopP.H.FinnDiane Study Group. Heritability of proliferative diabetic retinopathy. Diabetes2008; 57: 2176–80.
33.
SeaquistE.R., GoetzF.C., RichS., BarbosaJ.Familial clustering of diabetic kidney disease. Evidence for genetic susceptibility to diabetic nephropathy. N Engl J Med1989; 320: 1161–5.
34.
FaronatoP.P., MaioliM., TonoloG.Clustering of albumin excretion rate abnormalities in Caucasian patients with NIDDM. The Italian NIDDM Nephropathy Study Group. Diabetologia1997; 40: 816–23.
35.
PettittD.J., SaadM.F., BennettP.H., NelsonR.G., KnowlerW.C.Familial predisposition to renal disease in two generations of Pima Indians with type 2 (non insulin dependent) diabetes mellitus. Diabetologia1990; 33: 438–43.
36.
KrolewskiA.S., CanessaM., WarramJ.H.Predisposition to hypertension and susceptibility to renal disease in insulin dependent diabetes mellitus. N Engl J Med1988; 318: 140–5.
37.
CananiL.H., GerchmanF., GrossJ.L.Familial clustering of diabetic nephropathy in Brazilian type 2 diabetic patients. Diabetes1999; 48: 909–13.
38.
VijayV., SnehalathaC., ShinaK., LalithaS., RamachandranA.Familial aggregation of diabetic kidney disease in Type 2 diabetes in south India. Diabetes Res Clin Pract1999; 43: 167–71.
ThornL.M., ForsblomC., FageruddJ.Clustering of risk factors in parents of patients with type 1 diabetes and nephropathy. Diabetes Care2007; 30: 1162–7.
41.
HarjutsaloV., KatohS., SartiC., TajimaN., TuomilehtoJ.Population-based assessment of familial clustering of diabetic nephropathy in type 1 diabetes. Diabetes2004; 53: 2449–54.
LloydC.E., OrchardT.J.Diabetes complications: the renal-retinal link. An epidemiological perspective. Diabetes Care1995; 18: 1034–6.
44.
CaiX.L., WangF., JiL.N.Risk factors of diabetic retinopathy in type 2 diabetic patients. Chin Med J (Engl)2006; 119: 822–6.
45.
MossS.E., KleinR., KleinB.E.Cigarette smoking and ten-year progression of diabetic retinopathy. Ophthalmology1996; 103: 1438–42.
46.
StrattonI.M., KohnerE.M., AldingtonS.J.UKPDS 50. risk factors for incidence and progression of retinopathy in type II diabetes over 6 years from diagnosis. Diabetologia2001; 44: 156–63.
