Associations Between Diabetic Retinopathy and Frailty: Insights From the National Health and Nutrition Examination Survey and Mendelian Randomization.

IF 2.6 3区医学 Q2 OPHTHALMOLOGY Translational Vision Science & Technology Pub Date : 2025-02-03 DOI:10.1167/tvst.14.2.2

Jianqi Chen, Xuhao Chen, Xu Cao, Xiaohua Zhuo, Yuwen Wen, Guitong Ye, Yuan Zhang, Jinan Zhan, Hongmei Tan, Yingting Zhu, Yehong Zhuo

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Abstract

Purpose: To elucidate the relationship between diabetic retinopathy (DR) and frailty and investigate genetic correlations and causality.

Methods: We analyzed data from the US National Health and Nutrition Examination Survey, which included 1003 individuals with diabetes. DR was evaluated via nonmydriatic retinal imaging, and frailty was measured using a 49-item frailty index. The association between DR and frailty was assessed using survey-weighted logistics regression adjusted for multiple covariates, including age, sex, race, education level, family income-to-poverty ratio, marital status, and Healthy Eating Index. Genetic correlations and causal relationships were investigated through linkage disequilibrium score regression and bidirectional Mendelian randomization.

Results: DR was significantly associated with higher odds of frailty after full adjustment (odd ratio [OR] = 4.25; 95% confidence interval [CI], 1.08-16.67; P = 0.040). The association was robust and did not significantly differ across age (P interaction = 0.080), sex (P interaction = 0.216), or race (P interaction = 0.749) groups. DR exhibited a moderate but significant genetic correlation with frailty (rg = 0.27, standard error = 0.04; P = 2.43 × 10-10). Genetically inferred DR was significantly associated with a greater frailty index (β = 0.03; 95% CI, 0.01-0.05; P < 0.001), whereas frailty was not associated with DR risk (OR = 1.20; 95% CI, 0.80-1.81; P = 0.376).

Conclusions: Our findings suggest that DR is associated with an increased risk of frailty, indicating that DR not only impairs vision but also accelerates physical decline.

Translational relevance: This study highlights the critical need for integrated care approaches that incorporate frailty screening and proactive management in individuals with DR to prevent further health deterioration and improve both quality of life and long-term outcomes.

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糖尿病视网膜病变和虚弱之间的关系：来自全国健康和营养检查调查和孟德尔随机化的见解。

目的：探讨糖尿病视网膜病变（DR）与衰弱的关系，探讨遗传相关性和因果关系。方法：我们分析了来自美国国家健康与营养检查调查的数据，其中包括1003名糖尿病患者。DR通过非散瞳视网膜成像进行评估，虚弱程度采用49项虚弱指数进行测量。采用调查加权logistic回归对多个协变量（包括年龄、性别、种族、教育水平、家庭收入与贫困比、婚姻状况和健康饮食指数）进行调整，评估DR与虚弱之间的关系。通过连锁不平衡评分回归和双向孟德尔随机化研究遗传相关性和因果关系。结果：DR与完全调整后较高的虚弱几率显著相关(奇比[OR] = 4.25；95%置信区间[CI]， 1.08-16.67；P = 0.040)。这种关联是稳健的，在年龄（P交互作用= 0.080）、性别（P交互作用= 0.216）或种族（P交互作用= 0.749）组之间没有显著差异。DR与脆弱表现出中度但显著的遗传相关性(rg = 0.27，标准误差= 0.04；P = 2.43 × 10-10)。遗传推断DR与较高的脆弱指数显著相关(β = 0.03；95% ci, 0.01-0.05；P < 0.001)，而虚弱与DR风险无关(OR = 1.20；95% ci, 0.80-1.81；P = 0.376)。结论：我们的研究结果表明，DR与身体虚弱的风险增加有关，这表明DR不仅损害视力，而且加速身体衰退。转化相关性：本研究强调了综合护理方法的迫切需要，包括虚弱筛查和DR患者的主动管理，以防止进一步的健康恶化，改善生活质量和长期预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Translational Vision Science & Technology Engineering-Biomedical Engineering

CiteScore

5.70

自引率

3.30%

发文量

346

审稿时长

25 weeks

期刊介绍： Translational Vision Science & Technology (TVST), an official journal of the Association for Research in Vision and Ophthalmology (ARVO), an international organization whose purpose is to advance research worldwide into understanding the visual system and preventing, treating and curing its disorders, is an online, open access, peer-reviewed journal emphasizing multidisciplinary research that bridges the gap between basic research and clinical care. A highly qualified and diverse group of Associate Editors and Editorial Board Members is led by Editor-in-Chief Marco Zarbin, MD, PhD, FARVO. The journal covers a broad spectrum of work, including but not limited to: Applications of stem cell technology for regenerative medicine, Development of new animal models of human diseases, Tissue bioengineering, Chemical engineering to improve virus-based gene delivery, Nanotechnology for drug delivery, Design and synthesis of artificial extracellular matrices, Development of a true microsurgical operating environment, Refining data analysis algorithms to improve in vivo imaging technology, Results of Phase 1 clinical trials, Reverse translational ("bedside to bench") research. TVST seeks manuscripts from scientists and clinicians with diverse backgrounds ranging from basic chemistry to ophthalmic surgery that will advance or change the way we understand and/or treat vision-threatening diseases. TVST encourages the use of color, multimedia, hyperlinks, program code and other digital enhancements.