文献类型：期刊文献

英文题名：The linear association between estimated glomerular filtration rate and diabetic retinopathy: a cross-sectional study

作者：Ling, Juan[1,2];Xie, ZhuoLin[3];Zhang, Dongpeng[3];Gao, Ying[2];Hu, YiMing[2];Chen, Xinlin[4,5];Luo, Xiangxia[3]

第一作者：Ling, Juan

通信作者：Luo, XX[1]

机构：[1]Gansu Prov Hosp, Lanzhou 730050, Gansu, Peoples R China;[2]Gansu Univ Chinese Med, Clin Coll Chinese Med, Lanzhou 730030, Gansu, Peoples R China;[3]Gansu Prov Hosp TCM, Lanzhou 730050, Gansu, Peoples R China;[4]Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Dept Geriatr, Wuhan, Peoples R China;[5]Empower U X&Y Solut Inc, Dept Epidemiol & Biostat, Boston, MA USA

第一机构：Gansu Prov Hosp, Lanzhou 730050, Gansu, Peoples R China

通信机构：[1]corresponding author), Gansu Prov Hosp TCM, Lanzhou 730050, Gansu, Peoples R China.

年份：2026

卷号：16

期号：1

外文期刊名：SCIENTIFIC REPORTS

收录：;Scopus(收录号：2-s2.0-105052605397);WOS:【SCI-EXPANDED(收录号:WOS:001895938600033)】；

基金：This study was funded by National Natural Science Foundation of China (No. 82360955 and 82460897); Gansu Provincial Natural Science Foundation Excellent PhD Graduate Project (No. 24JRRA614); Research Fund Project of Gansu Provincial People's Hospital (No. 25GSSYB-9); Research Project of the Gansu Provincial Medical Products Administration (No. 2025GSMPA064); Scientific Research Program Project of the Gansu Provincial Health Commission (No.CSWSKY2022-44), Gansu Provincial Health Industry Science and Technology Inno vation Major Project Contract (GSWSZD2024-05).

语种：英文

外文关键词：Estimated glomerular filtration rate; Diabetic retinopathy; Association

摘要：Diabetic retinopathy (DR) is the predominant microvascular complication of diabetes and the main cause of preventable blindness in working-age adults. Because the retina and kidney share similar microvascular architecture, renal dysfunction-routinely expressed as the estimated glomerular filtration rate (eGFR)-is biologically plausible as a marker of DR risk. However, the relationship between eGFR and DR remains controversial. This study aimed to investigate the association between eGFR and DR prevalence in diabetic patients with type 2 diabetes mellitus. This study represents a secondary analysis of data derived from a cross-sectional study. We included 2001 adults with diabetes mellitus (858 men and 1143 women; mean age 64.0 +/- 11.3 years) who attended the internal-medicine outpatient clinics of two hospitals in southern Taiwan between April 2002 and November 2004. Demographic and clinical variables were recorded, and eGFR was calculated using the simplified MDRD equation. The association between eGFR and DR was examined with multivariable logistic regression, adjusting for potential confounders. To explore potential non-linear relationships, we further applied a generalized additive model (GAM) with smooth-spline fitting. Higher eGFR was inversely associated with the odds of DR across progressively adjusted models. When modeled as a continuous variable, higher eGFR was linked to lower DR odds in Model 1 (OR 0.88; 95% CI 0.83-0.92; P < 0.0001), Model 2 (OR 0.90; 95% CI 0.85-0.95; P < 0.0001), and remained significant after full adjustment in Model 3 (OR 0.92; 95% CI 0.87-0.98; P = 0.0056), indicating a robust inverse association. Compared with the lowest eGFR tertile (15.36-60.50 mL/min/1.73 m(2)), the highest tertile (76.68-141.22 mL/min/1.73 m(2)) showed a 30% lower risk of DR (adjusted OR 0.70, 95% CI 0.50-0.90). Smooth-spline analysis confirmed a linear inverse relationship, and no significant effect modification was observed across subgroups of age, sex, BMI, blood pressure, glycaemic control or cardiovascular comorbidities. This cross-sectional analysis demonstrates a clear dose-response pattern: each incremental increase in estimated glomerular filtration rate (eGFR) is associated with a proportional reduction in the likelihood of diabetic retinopathy among adults with type 2 diabetes mellitus. Future work should dissect the shared microvascular pathways linking the kidney and retina and determine whether interventions that preserve renal function can translate into meaningful reductions in retinopathy risk.