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. 2018 Aug 15;8(1):12164.
doi: 10.1038/s41598-018-30521-7.

Nomogram for prediction of non-proliferative diabetic retinopathy in juvenile-onset type 1 diabetes: a cohort study in an Asian population

Eugene Yu-Chuan Kang  1   2 , Fu-Sung Lo  2   3 , Jung-Pan Wang  4   5 , Lung-Kun Yeh  1   2 , An-Lun Wu  1   2 , Yun-Ju Tseng  6 , Chun-Ting Yeh  1   2 , Laura Liu  1   2   7 , Kuan-Jen Chen  1   2 , Wei-Chi Wu  1   2 , Chi-Chun Lai  1   2 , Nan-Kai Wang  8   9   10 ; Chang Gung Juvenile Diabetes Eye Study Group
Collaborators, Affiliations

Nomogram for prediction of non-proliferative diabetic retinopathy in juvenile-onset type 1 diabetes: a cohort study in an Asian population

Eugene Yu-Chuan Kang et al. Sci Rep. .

Abstract

The need for screening for retinopathy in patients with type 1 diabetes mellitus (T1DM) has been emphasised, but diagnostic delays were reported when screening was done at fixed intervals. To establish an individualised risk-prediction model to assist screening non-proliferative diabetic retinopathy (NPDR) in T1DM, we performed a retrospective cohort study enrolling participants in the Chang Gung Juvenile Diabetes Eye Study. There were 413 patients with 12 381 records analysed from 2005 to 2015. A time-dependent Cox proportional hazard analysis was used to evaluate the risks of NPDR development and a nomogram with risk-stratification indicators was established based on the results. During 97 months of follow-up, 43 of 413 patients (10.4%) developed NPDR. Male sex (HR: 0.4, 95% CI: 0.19-0.85), age 5-14 years at onset of T1DM (6.38, 2.41-16.87), duration of diabetes (1.57, 1.41-1.75), and hemoglobin A1c level (1.56, 1.35-1.80) were independently associated with NPDR. Using the nomogram offers a quick method in the clinical setting to interpret the risk of NPDR development. Based on its weighting, each of the independent factors is allocated a score, and the total points indicate the probabilities of NPDR occurring within 6 months, 1 year, and 3 years.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
The distribution of study participants. T1DM: type 1 diabetes mellitus, NPDR: non-proliferative diabetic retinopathy, HbA1c: hemoglobin A1c.
Figure 2
Figure 2
Prediction model for non-proliferative diabetic retinopathy. T1DM: type 1 diabetes mellitus, yrs: years, HbA1c: hemoglobin A1c, NPDR: non-proliferative diabetic retinopathy.
Figure 3
Figure 3
Correlation between age and HbA1c stratified by the presence of non-proliferative diabetic retinopathy (circles) and the absence of diabetic retinopathy (triangles). Mean of the HbA1c in the presence of non-proliferative diabetic retinopathy and the absence of diabetic retinopathy were presented as solid line and dashed line, respectively. HbA1c: hemoglobin A1c.
See this image and copyright information in PMC

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