ArticleDiabetes care2019
Retinopathy and RAAS Activation: Results From the Canadian Study of Longevity in Type 1 Diabetes.
Article in Diabetes care, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- Association of ACE and AGTR1 variants with retinopathy of prematurity: a case-control study and meta-analysis.Journal of applied genetics · 2025Pooled it
- Association of arterial stiffness and eye disease: a systematic review and meta-analysis.BMJ open ophthalmology · 2025Pooled it
- SNAI2/SLUG: a key regulator of endothelial-to-mesenchymal transition and vascular remodeling in cardiovascular diseases.Journal of cardiothoracic surgery · 2026Review
- Plasma proteomic signatures of early retinal neurodegeneration in diabetes: A multi-cohort study.PLoS medicine · 2026Observational
- The role of immunoproteasome in diabetes and diabetes-related complications.Genes & diseases · 2026Review
- Systems biology and microbiome innovations for personalized diabetic retinopathy management.NPJ systems biology and applications · 2025Review
- Diabetic retinopathy: a comprehensive review of pathophysiology and emerging treatments.Molecular biology reports · 2025Review
- A Machine Learning Model for Predicting Diabetic Nephropathy Based on TG/Cys-C Ratio and Five Clinical Indicators.Diabetes, metabolic syndrome and obesity : targets and therapy · 2025Article
- Updates on the Renin-Angiotensin-Aldosterone System and the Cardiovascular Continuum.Biomedicines · 2024Review
- RAAS in diabetic retinopathy: mechanisms and therapies.Archives of endocrinology and metabolism · 2024Review
- Parallelism and non-parallelism in diabetic nephropathy and diabetic retinopathy.Frontiers in endocrinology · 2024Review
- The role of aldosterone in the pathogenesis of diabetic retinopathy.Frontiers in endocrinology · 2023Review
- Spotlight on iron and ferroptosis: research progress in diabetic retinopathy.Frontiers in endocrinology · 2023Review
- Arterial Stiffness in Type 1 Diabetes: The Case for the Arterial Wall Itself as a Target Organ.Journal of clinical medicine · 2021Review
- Discoveries from the study of longstanding type 1 diabetes.Diabetologia · 2021Review
- Protection from neuropathy in extreme duration type 1 diabetes.Journal of the peripheral nervous system : JPNS · 2021Article
- Glycemia Lowering Effect of an Aqueous Extract ofNutrients · 2019Article
- Diabetic Retinopathy May Indicate an Increased Risk of Cardiovascular Disease in Patients With Type 1 Diabetes-A Nested Case-Control Study in Brazil.Frontiers in endocrinology · 2019Article
- In Vivo Visualization and Quantification of Optic Disc Microvasculature for Assessing Renal Dysfunction.Ophthalmology scienceArticle
Corrections and comments
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Authors and funding
18 authors at 7 institutions in 2 countries.
Funding
Abstract
objectiveThe importance of renin-angiotensin-aldosterone system (RAAS) activation in retinopathy for long-standing diabetes is not well understood. We determined retinopathy stage and evaluated associations with other vascular complications before and after physiological RAAS activation in adults with long-standing (≥50 years duration) type 1 diabetes. RESEARCH DESIGN AND
methodsParticipants underwent retinal examination by digital funduscopic photography and optical coherence tomography and were classified as having nonproliferative diabetic retinopathy (NPDR), proliferative diabetic retinopathy (PDR), or no diabetic retinopathy (NDR) with or without diabetic macular edema (DME). Neuropathy was measured by clinical neuropathy examination scores, electrophysiologically, and by corneal confocal microscopy. Renal function was measured by inulin and para-aminohippurate clearance methods. Arterial stiffness was measured by applanation tonometry. Renal function, blood pressure, and arterial stiffness were measured before and after RAAS activation with angiotensin II (ANGII). Associations were determined using linear regression.
resultsTwelve (16%) of the 75 participants had NDR, 24 (32%) had NPDR, and 39 (52%) had PDR. A low overall prevalence of DME (4%) was observed. Those with PDR had worse nerve function and reduced corneal nerve density, were more likely to have macrovascular disease, and had increased arterial stiffness in response to ANGII compared with those with NPDR or NDR. Prevalence of kidney disease or renal hemodynamic function did not differ by retinopathy status.
conclusionsPDR was associated with neuropathy severity and cardiovascular and peripheral vascular disease. In those with PDR, RAAS activation may be linked to vascular stiffening, an effect that persists in long-standing type 1 diabetes.
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Registered trials
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