Association between endothelial activation and stress index and diabetic retinopathy in patients with diabetic kidney...

To investigate the association between Endothelial Activation and Stress Index (EASIX) and diabetic retinopathy (DR) among patients with diabetic kidney disease (DKD).

A cross-sectional study was conducted based on the National Health and Nutrition Examination Survey (NHANES) database. Participants were divided into quartiles according to EASIX scores. Survey-weighted generalized linear models (SWGLMs) were used to evaluate the association between EASIX and DR, with restricted cubic spline (RCS) analysis to examine non-linear relationships. Stratified analyses were performed by gender, race, age, Body Mass Index (BMI), smoking status, alcohol consumption, blood pressure, and renal function.

After multivariate adjustment, each unit increase in EASIX was associated with a 32% higher risk of DR (OR: 1.32, 95% CI: 1.04-1.69, P = 0.024). In quartile analysis, compared with the first quartile, the fourth quartile showed a trend toward increased DR risk (OR: 1.60, 95% CI: 0.99-2.59, P = 0.054), with a significant dose-response trend (P for trend = 0.040). RCS analysis revealed a significant overall association between EASIX and DR (P for overall < 0.001), while the non-linear association was not significant (P for nonlinear = 0.075). Stratified analyses demonstrated that this association remained consistent across different population characteristics.

EASIX is significantly associated with DR in DKD patients and may serve as a potential marker for DR risk assessment.