التفاصيل البيبلوغرافية
| العنوان: |
Effect of lisinopril on progression of retinopathy in normotensive people with type 1 diabetes. The EUCLID Study Group. EURODIAB Controlled Trial of Lisinopril in Insulin-Dependent Diabetes Mellitus. |
| المؤلفون: |
Chaturvedi N (AUTHOR), Sjolie A (AUTHOR), Stephenson JM (AUTHOR), Abrahamian H (AUTHOR), Keipes M (AUTHOR), Castellarin A (AUTHOR), Rogulja-Pepeonik Z (AUTHOR), Fuller JH (AUTHOR), EUCLID Study Group (CORPORATE AUTHOR), Chaturvedi, N1 (AUTHOR), Sjolie, A K (AUTHOR), Stephenson, J M (AUTHOR), Abrahamian, H (AUTHOR), Keipes, M (AUTHOR), Castellarin, A (AUTHOR), Rogulja-Pepeonik, Z (AUTHOR), Fuller, J H (AUTHOR) |
| المصدر: |
Lancet. 1/3/1998, Vol. 351 Issue 9095, p28-31. 4p. |
| مستخلص: |
Background: Retinopathy commonly occurs in people with type 1 diabetes. Strict glycaemic control can decrease development and progression of retinopathy only partially. Blood pressure is also a risk factor for microvascular complications. Antihypertensive therapy, especially with inhibitors of angiotensin-converting enzyme (ACE), can slow progression of nephropathy, but the effects on retinopathy have not been established. We investigated the effect of lisinopril on retinopathy in type 1 diabetes.Methods: As part of a 2-year randomised double-blind placebo-controlled trial, we took retinal photographs at baseline and follow-up (24 months) in patients aged 20-59 in 15 European centres. Patients were not hypertensive, and were normoalbuminuric (85%) or microalbuminuric. Retinopathy was classified from photographs on a five-level scale (none to proliferative).Findings: The proportion of patients with retinopathy at baseline was 65% (117) in the placebo group and 59% (103) in the lisinopril group (p = 0.2). Patients on lisinopril had significantly lower HbA1c at baseline than those on placebo (6.9% vs 7.3 p = 0.05). Retinopathy progressed by at least one level in 21 (13.2%) of 159 patients on lisinopril and 39 (23.4%) of 166 patients on placebo (odds ratio 0.50 [95% CI 0.28-0.89], p = 0.02). This 50% reduction was the same when adjusted for centre and glycaemic control (0.55 [0.30-1.03], p = 0.06). Lisinopril also decreased progression by two or more grades (0.27 [0.07-1.00], p = 0.05), and progression to proliferative retinopathy (0.18 [0.04-0.82], p = 0.03). Progression was not associated with albuminuric status at baseline. Treatment reduced retinopathy incidence (0.69 [0.30-1.59], p = 0.4).Interpretation: Lisinopril may decrease retinopathy progression in non-hypertensive patients who have type 1 diabetes with little or no nephropathy. These findings need to be confirmed before changes to clinical practice can be advocated. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
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