{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T19:37:34Z","timestamp":1789587454759,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2013,8,28]],"date-time":"2013-08-28T00:00:00Z","timestamp":1377648000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet. Med."],"published-print":{"date-parts":[[2013,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>Little is known about the dynamic relationship over time between diabetic retinopathy and nephropathy. Thus, we sought to evaluate the concordance over time of retinopathy and nephropathy in patients with Type\u00a01 diabetes during the Diabetes Control and Complications Trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This analysis was conducted in patients with Type\u00a01 diabetes participating in the Diabetes Control and Complications Trial. Only participants with urinary albumin excretion rate &lt;\u00a040\u00a0mg\/24\u00a0h were included in the analysis (<jats:italic>n<\/jats:italic>\u00a0=\u00a01365). We evaluated the relationship between the progression of retinopathy and the development of nephropathy over a mean 6.5\u00a0years of follow\u2010up. Progression of retinopathy was defined by 3\u2010step change in Early Treatment Diabetic Retinopathy Study score on consecutive annual evaluations. Development of nephropathy was defined as incidence of urinary albumin excretion rate \u2265\u00a040\u00a0mg\/24\u00a0h on annual evaluation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Over a mean 6.5\u00a0years of follow\u2010up, the incidence of progression of retinopathy was higher in those who developed nephropathy than in those who did not (36.2 vs. 13.4%; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). The development of nephropathy independently increased the risk for progression of retinopathy (hazard ratio\u00a01.62, 95%\u00a0CI 1.23\u20132.13, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.001), after adjustment for age, gender, diabetes duration, treatment, HbA<jats:sub>1c<\/jats:sub>, BMI, HDL cholesterol and blood pressure. Similarly, the incidence of nephropathy was higher in participants who had progression of retinopathy than in those who did not (40.7 vs. 15.7%; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). Furthermore, progression of retinopathy independently increased the risk for development of nephropathy (hazard ratio\u00a01.72, 95%\u00a0CI 1.30\u20132.27, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Progression of retinopathy and development of nephropathy each increase the risk for incidence of the other, independent of established risk factors for microvascular complications, supporting the notion of a shared aetiologic basis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.12296","type":"journal-article","created":{"date-parts":[[2013,8,3]],"date-time":"2013-08-03T07:08:42Z","timestamp":1375513722000},"page":"1333-1341","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Concordance of retinopathy and nephropathy over time in Type\u00a01 diabetes: an analysis of data from the Diabetes Control and Complications Trial"],"prefix":"10.1111","volume":"30","author":[{"given":"C. K.","family":"Kramer","sequence":"first","affiliation":[{"name":"Leadership Sinai Centre for Diabetes Mount Sinai Hospital"},{"name":"Division of Endocrinology University of Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Retnakaran","sequence":"additional","affiliation":[{"name":"Leadership Sinai Centre for Diabetes Mount Sinai Hospital"},{"name":"Division of Endocrinology University of Toronto"},{"name":"Samuel Lunenfeld Research Institute Mount Sinai Hospital Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,8,28]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2009.193"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199309303291401"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.287.19.2563"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.1995.tb00528.x"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc11-1955"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2012.06.010"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8227(97)00106-X"},{"key":"e_1_2_7_9_1","doi-asserted-by":"crossref","first-page":"530","DOI":"10.2337\/diab.35.5.530","article-title":"Design and methodologic considerations for the feasibility phase. The DCCT Research Group","volume":"35","author":"The Diabetes Control and Complications Trial","year":"1986","journal-title":"Diabetes"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.13.4.427"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.1995.01100010038019"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1995.236"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1014409829614"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.2337\/diab.43.3.441"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.25.5.859"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.2337\/diabetes.54.2.527"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s001250051594"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1755-3768.1985.tb05240.x"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12265-012-9385-4"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.22.5.779"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1992.03490210061036"},{"key":"e_1_2_7_22_1","doi-asserted-by":"crossref","first-page":"1829","DOI":"10.2337\/diab.46.11.1829","article-title":"Clustering of long\u2010term complications in families with diabetes in the Diabetes Control and Complications Trial","volume":"46","author":"The Diabetes Control and Complications Trial Research Group","year":"1997","journal-title":"Diabetes"},{"key":"e_1_2_7_23_1","first-page":"342","article-title":"Genetic factors in the development of diabetic nephropathy","volume":"126","author":"Trevisan R","year":"1995","journal-title":"J Lab Clin Med"},{"key":"e_1_2_7_24_1","doi-asserted-by":"crossref","first-page":"1653","DOI":"10.1681\/ASN.V991653","article-title":"Association between the angiotensin\u2010converting enzyme\u2010insertion\/deletion polymorphism and diabetic nephropathy: a methodologic appraisal and systematic review","volume":"9","author":"Kunz R","year":"1998","journal-title":"J Am Soc Nephrol"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ki.5000348"},{"key":"e_1_2_7_26_1","doi-asserted-by":"crossref","first-page":"1358","DOI":"10.2337\/diab.43.11.1358","article-title":"Glomerular structure in nonproteinuric IDDM patients with various levels of albuminuria","volume":"43","author":"Fioretto P","year":"1994","journal-title":"Diabetes"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365518509155256"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa021835"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.2337\/diabetes.49.9.1399"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc07-0387"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc13-S011"}],"container-title":["Diabetic Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fdme.12296","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.12296","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T05:09:20Z","timestamp":1696309760000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/dme.12296"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,8,28]]},"references-count":30,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2013,11]]}},"alternative-id":["10.1111\/dme.12296"],"URL":"https:\/\/doi.org\/10.1111\/dme.12296","archive":["Portico"],"relation":{},"ISSN":["0742-3071","1464-5491"],"issn-type":[{"value":"0742-3071","type":"print"},{"value":"1464-5491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,8,28]]},"assertion":[{"value":"2013-07-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-08-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}