Diabetic retinopathy is a predictor of chronic respiratory failure: A nationwide register-based cohort study
Benjamin Sommer Thinggaard,
Lonny Stokholm,
Jesper Rømhild Davidsen,
Maria Carius Larsen,
Sören Möller,
Anne Suhr Thykjær,
Jens Lundgaard Andresen,
Nis Andersen,
Steffen Heegaard,
Kurt Højlund,
Ryo Kawasaki,
Caroline Laugesen,
Toke Bek,
Jakob Grauslund
Affiliations
Benjamin Sommer Thinggaard
Department of Ophthalmology, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark; OPEN – Open Patient Data Explorative Network, Odense University Hospital & University of Southern Denmark, Odense, Denmark; Corresponding author. Department of Ophthalmology Odense University Hospital J. B. Winsløws Vej 4 DK-5000 Odense C Denmark.
Lonny Stokholm
Department of Clinical Research, University of Southern Denmark, Odense, Denmark; OPEN – Open Patient Data Explorative Network, Odense University Hospital & University of Southern Denmark, Odense, Denmark
Jesper Rømhild Davidsen
Department of Clinical Research, University of Southern Denmark, Odense, Denmark; South Danish Center for Interstitial Lung Diseases (SCILS), Department of Respiratory Medicine, Odense University Hospital, Odense, Denmark; Odense Respiratory Research Unit (ODIN), Department of Clinical Research, University of Southern Denmark, Odense, Denmark
Maria Carius Larsen
Department of Ophthalmology, Odense University Hospital, Odense, Denmark
Sören Möller
Department of Clinical Research, University of Southern Denmark, Odense, Denmark; OPEN – Open Patient Data Explorative Network, Odense University Hospital & University of Southern Denmark, Odense, Denmark
Anne Suhr Thykjær
Department of Ophthalmology, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark; OPEN – Open Patient Data Explorative Network, Odense University Hospital & University of Southern Denmark, Odense, Denmark
Jens Lundgaard Andresen
Organization of Danish Practicing Ophthalmologists, Copenhagen, Denmark
Nis Andersen
Organization of Danish Practicing Ophthalmologists, Copenhagen, Denmark
Steffen Heegaard
Department of Ophthalmology, Rigshospitalet-Glostrup, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
Kurt Højlund
Department of Clinical Research, University of Southern Denmark, Odense, Denmark; OPEN – Open Patient Data Explorative Network, Odense University Hospital & University of Southern Denmark, Odense, Denmark
Ryo Kawasaki
Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Department of Vision Informatics, University of Osaka, Osaka, Japan
Caroline Laugesen
Department of Ophthalmology, Zealand University Hospital Roskilde, Roskilde, Denmark
Toke Bek
Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
Jakob Grauslund
Department of Ophthalmology, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
Purpose: Diabetic retinopathy (DR) is a hypoxic retinal disease, but so far, the association with systemic hypoxia is poorly understood. Hence, the aim of this study was to evaluate cross-sectional and longitudinal associations between DR and chronic respiratory failure (CRF) in a national cohort. Design: Cross-sectional and 5-year longitudinal register-based cohort study. Methods: Between 2013 and 2018, we included patients with diabetes from the Danish Registry of Diabetic Retinopathy, who were each age and sex matched with five controls without diabetes. At index date, the prevalence of CRF was compared between cases and controls, and the longitudinal relationship between DR and CRF was assessed in a five-year follow-up. Results: At baseline, we identified 1,980 and 9,990 patients with CRF among 205,970 cases and 1,003,170 controls. The prevalence of CRF was higher among cases than controls (OR 1.75, 95% CI 1.65–1.86), but no difference between cases with and without DR was found.During follow-up, we identified 1,726 and 5,177 events of CRF among cases and controls, respectively. The incidence of CRF was higher among both cases with and without DR compared to controls (DR level 0: HR 1.24, 95% CI 1.16–1.33, DR level 1–4: HR 1.86, 95% CI 1.63–2.12), and higher among cases with DR compared to cases without DR (HR 1.54, 95% CI 1.38–1.72). Conclusion: In this study based on nationwide data, we found an increased risk of present and incident CRF in patients with diabetes with or without DR, and we identified DR as a predictor of future CRF.
