Prior Cardiovascular Disease and Incident Diabetic Retinopathy in Newly Diagnosed Type 2 Diabetes Mellitus
9 affiliations
- 1Department of Plastic and Reconstructive Surgery, Myongji Hospital, Myongji Medical Foundation, Goyang 10475, Republic of Korea
- 2Department of Pre-Medicine, Hanyang University College of Medicine, Seoul 04763, Republic of Korea
- 3Biostatistics Laboratory, Medical Research Collaborating Center, Hanyang University, Seoul 04763, Republic of Korea
- 4Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
- 5Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangzhou 510080, China
- 6Department of Internal Medicine, Graduate School, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- 7Mediwhale Inc., Seoul 06049, Republic of Korea
- 8Department of Ophthalmology, Hanyang University Guri Hospital, Guri 11923, Republic of Korea
- 9Department of Ophthalmology, Hanyang University College of Medicine, Seoul 04763, Republic of Korea
Abstract
Background/Objectives: To determine whether prior cardiovascular disease (CVD) independently predicts diabetic retinopathy (DR) in adults with newly diagnosed type 2 diabetes mellitus (T2DM). Methods: A retrospective nationwide population-based cohort study was conducted using the Korean National Health Insurance Service database. Adults aged ≥40 years with newly diagnosed T2DM were identified after a 7-year washout period. After 1:1 propensity score matching on age and sex, the analytical cohort comprised 38,812 patients per group. Results: After full covariate adjustment, prior CVD was not independently associated with any DR (HR, 1.01; 95% confidence interval [CI], 0.99–1.04; p = 0.262), NPDR (HR, 1.01; 95% CI, 0.98–1.03; p = 0.605), PDR (HR, 1.01; 95% CI, 0.95–1.06; p = 0.835), or VTDR (HR, 1.00; 95% CI, 0.95–1.06; p = 0.893). Fine–Gray models, accounting for higher all-cause mortality in the prior CVD group after matching (25.2% vs. 22.1%), revealed slightly lower sHR for any DR (sHR, 0.97; 95% CI, 0.95–0.99; p = 0.014) and NPDR (sHR, 0.97; 95% CI, 0.94–0.99; p = 0.005). Conclusions: Prior CVD was not independently associated with incident DR. The lower sHRs may partly reflect competing mortality and should not be interpreted as DR protection. Overall, CVD history was not a criterion for intensified DR screening.
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BibTeX
@article{yoon2026prior,
title = {{Prior Cardiovascular Disease and Incident Diabetic Retinopathy in Newly Diagnosed Type 2 Diabetes Mellitus}},
author = {Jung Soo Yoon and Jiyeong Kim and Lei Liu and Dongjin Nam and Sunjin Hwang},
journal = {Journal of Clinical Medicine},
year = {2026},
month = nov,
doi = {10.3390/jcm15218544},
url = {https://www.mdpi.com/2077-0383/15/21/8544},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Prior Cardiovascular Disease and Incident Diabetic Retinopathy in Newly Diagnosed Type 2 Diabetes Mellitus
AU - Jung Soo Yoon
AU - Jiyeong Kim
AU - Lei Liu
AU - Dongjin Nam
AU - Sunjin Hwang
PY - 2026
DA - 2026/11/03
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15218544
UR - https://www.mdpi.com/2077-0383/15/21/8544
AB - Background/Objectives: To determine whether prior cardiovascular disease (CVD) independently predicts diabetic retinopathy (DR) in adults with newly diagnosed type 2 diabetes mellitus (T2DM). Methods: A retrospective nationwide population-based cohort study was conducted using the Korean National Health Insurance Service database. Adults aged ≥40 years with newly diagnosed T2DM were identified after a 7-year washout period. After 1:1 propensity score matching on age and sex, the analytical cohort comprised 38,812 patients per group. Results: After full covariate adjustment, prior CVD was not independently associated with any DR (HR, 1.01; 95% confidence interval [CI], 0.99–1.04; p = 0.262), NPDR (HR, 1.01; 95% CI, 0.98–1.03; p = 0.605), PDR (HR, 1.01; 95% CI, 0.95–1.06; p = 0.835), or VTDR (HR, 1.00; 95% CI, 0.95–1.06; p = 0.893). Fine–Gray models, accounting for higher all-cause mortality in the prior CVD group after matching (25.2% vs. 22.1%), revealed slightly lower sHR for any DR (sHR, 0.97; 95% CI, 0.95–0.99; p = 0.014) and NPDR (sHR, 0.97; 95% CI, 0.94–0.99; p = 0.005). Conclusions: Prior CVD was not independently associated with incident DR. The lower sHRs may partly reflect competing mortality and should not be interpreted as DR protection. Overall, CVD history was not a criterion for intensified DR screening.
SN - 2077-0383
ER -