Showing papers by "Gadjah Mada University published in 2012"
TL;DR: The great potential of citrus fruits as natural product to be developed as not only the source of co-chemotherapeutic agents, but also phyto-estrogens is shown, making chemoprevention a challenging and a very rational strategy in future researches.
Abstract: Targeted therapy has been a very promising strategy of drug development research. Many molecular mechanims of diseases have been known to be regulated by abundance of proteins, such as receptors and hormones. Chemoprevention for treatment and prevention of diseases are continuously developed. Pre-clinical and clinical studies in chemoprevention field yielded many valuable data in preventing the onset of disease and suppressing the progress of their growth, making chemoprevention a challenging and a very rational strategy in future researches. Natural products being rich of flavonoids are those fruits belong to the genus citrus. Ethanolic extract of Citrus reticulata and Citrus aurantiifolia peels showed anticarcinogenic, antiproliferative, co-chemotherapeutic and estrogenic effects. Several examples of citrus flavonoids that are potential as chemotherapeutic agents are tangeretin, nobiletin, hesperetin, hesperidin, naringenin, and naringin. Those flavonoids have been shown to possess inhibition activity on certain cancer cells’ growth through various mechanisms. Moreover, citrus flavonoids also perform promising effect in combination with several chemotherapeutic agents against the growth of cancer cells. Some mechanisms involved in those activities are through cell cycle modulation, antiangiogenic effect, and apoptosis induction.Previous studies showed that tangeretin suppressed the growth of T47D breast cancer cells by inhibiting ERK phosphorylation. While in combination with tamoxifen, doxorubicin, and 5-FU, respectively, it was proven to be synergist on several cancer cells. Hesperidin and naringenin increased cytotoxicitity of doxorubicin on MCF-7 cells and HeLa cells. Besides, citrus flavonoids also performed estrogenic effect in vivo. One example is hesperidin having the ability to decrease the concentration of serum and hepatic lipid and reduce osteoporosis of ovariectomized rats. Those studies showed the great potential of citrus fruits as natural product to be developed as not only the source of co-chemotherapeutic agents, but also phyto-estrogens. Therefore, further study needs to be conducted to explore the potential of citrus fruits in overcoming cancer
202 citations
TL;DR: Results suggest significant positive relationships between the overall level of effective IT governance and the following mechanisms: the involvement of senior management in IT, the existence of ethic or culture of compliance in IT; and corporate communication systems.
Abstract: Effective IT governance will ensure alignment between IT and business goals. Organizations with ineffective IT governance will suffer due to poor performance of IT resources such as inaccurate information quality, inefficient operating costs, runaway IT project and even the demise of its IT department. This study seeks to examine empirically the individual IT governance mechanisms that influence the overall effectiveness of IT governance. Furthermore, this study examines the relationship of effective IT governance, the extent of IT outsourcing decisions within the organizations, and the level of IT Intensity in the organizations. We used structural equation modeling analysis to examine 110 responses from members of ISACA (Information Systems and Audit Control Association) Australia in which their organizations have outsourced their IT functions. Results suggest significant positive relationships between the overall level of effective IT governance and the following mechanisms: the involvement of senior management in IT, the existence of ethic or culture of compliance in IT, and corporate communication systems.
186 citations
TL;DR: In this paper, the authors proposed an approach based on the core policy objectives of the program to evaluate the community forestry outcomes, which alleviates the poverty of forest users, empowering them, and improving the condition of the forests.
171 citations
25 Oct 2012
TL;DR: Pedestrian Dead Reckoning (PDR), which is a pedestrian positioning technique using the accelerometer sensor to recognize pattern of steps, is an alternative method that has advantages in terms of infrastructure-independent and the variation of walking pattern will make some difficulties for the system to detect displacement.
Abstract: Nowadays, personal positioning systems are more necessary to build many location-based services. Pedestrian Dead Reckoning (PDR), which is a pedestrian positioning technique using the accelerometer sensor to recognize pattern of steps, is an alternative method that has advantages in terms of infrastructure-independent. However, the variation of walking pattern on each individual will make some difficulties for the system to detect displacement. This is really interested authors to develop a sensor-based positioning system that applied generally to all individuals. In the test, 15 test subjects was taken with the distance of each 10m, 20m and 30m. Experiment begins with the feasibility test of accelerometer sensor. In this work, a smartphone with average sampling rate 63.79 Hz and standard deviation of 1.293 is used to records the acceleration. Then, the acceleration data are analyzed to detect step and to estimate the travelled distance using several methods. Detection of steps are able to make an average error of 2.925%, while the most nearly correct displacement estimation is using Scarlet experimental method which is make a distance average error of 1.39metres at all the traveled distance.
149 citations
TL;DR: In this article, fine particles of BFA have been reused to prepare zeolite Na−X and Na−A with high purity using hydrothermal treatment by optimizing the process condition, i.e., curing time, Hydrothermal temperature and Si/Al molar ratio in the reaction mixture.
132 citations
TL;DR: In the Indonesian ALL population, in particular, myeloid antigen-expressing T-ALL patients had a higher chance of having induction failure, and expression of myeloids antigens was an independent adverse prognostic factor in this subgroup.
Abstract: The frequency of acute lymphoblastic leukemia (ALL) patients expressing myeloid antigens on their ALL cells varies between 5 and 36% in several different studies. The clinical relevance of myeloid antigen expression in childhood ALL is controversial. In Indonesian patients, no data were present. Therefore, in Yogyakarta, Indonesia, we analyzed 239 ALL patients who were immunophenotyped including myeloid markers (CD13, CD33, CD117, and/or cMPO). Myeloid antigen expression was found in 25% of patients. Expression of myeloid antigen in B-lineage leukemia was 27%, and in T-lineage leukemia, it was 18% (). No association was found between myeloid antigen expression and clinical or biological features. In the whole cohort of patients we did not find a significant association between myeloid antigen expression and survival, although leukemia-free survival at 3 years was higher in the myeloid-negative patients (73% ± 6%) compared to myeloid-positive patients (67% ± 8%). Interestingly, in T-ALL patients, expression of myeloid antigens was an independent adverse prognostic factor (hazard ratio: 3.26, 95% CI: 1.06–9.98, ). Kaplan-Meier analysis for event-free survival was also significant (log rank ) in this subgroup. In conclusion, in the Indonesian ALL population, in particular, myeloid antigen-expressing T-ALL patients had a higher chance of having induction failure.
122 citations
TL;DR: The fungal-, phosphoric acid-, and fungal followed by phosphoric Acid pretreatments have improved the digestibility of OPEFB’s cellulose by 4, 6.3, and 7.4 folds, respectively.
Abstract: Oil palm empty fruit bunch (OPEFB) was pretreated using white-rot fungus Pleurotus floridanus, phosphoric acid or their combination, and the results were evaluated based on the biomass components, and its structural and morphological changes. The carbohydrate losses after fungal, phosphoric acid, and fungal followed by phosphoric acid pretreatments were 7.89%, 35.65%, and 33.77%, respectively. The pretreatments changed the hydrogen bonds of cellulose and linkages between lignin and carbohydrate, which is associated with crystallinity of cellulose of OPEFB. Lateral Order Index (LOI) of OPEFB with no pretreatment, with fungal, phosphoric acid, and fungal followed by phosphoric acid pretreatments were 2.77, 1.42, 0.67, and 0.60, respectively. Phosphoric acid pretreatment showed morphological changes of OPEFB, indicated by the damage of fibre structure into smaller particle size. The fungal-, phosphoric acid-, and fungal followed by phosphoric acid pretreatments have improved the digestibility of OPEFB's cellulose by 4, 6.3, and 7.4 folds, respectively.
117 citations
TL;DR: The interrogation of different dimensions of care reveals the importance of contact with parents (both migrant and nonmigrant) to subjective child well-being, and the diversity of experiences and intimacies among children in the two study countries.
Abstract: As a significant supplier of labour migrants, Southeast Asia presents itself as an important site for the study of children in transnational families who are growing up separated from at least one migrant parent and sometimes cared for by 'other mothers'. Through the often-neglected voices of left-behind children, we investigate the impact of parental migration and the resulting reconfiguration of care arrangements on the subjective well-being of migrants' children in two Southeast Asian countries, Indonesia and the Philippines. We theorise the child's position in the transnational family nexus through the framework of the 'care triangle', representing interactions between three subject groups- 'left-behind' children, non-migrant parents/other carers; and migrant parent(s). Using both quantitative (from 1010 households) and qualitative (from 32 children) data from a study of child health and migrant parents in Southeast Asia, we examine relationships within the caring spaces both of home and of transnational spaces. The interrogation of different dimensions of care reveals the importance of contact with parents (both migrant and nonmigrant) to subjective child well-being, and the diversity of experiences and intimacies among children in the two study countries.
115 citations
TL;DR: The purified extract of the plant and its active compound andrographolide significantly decreased the levels of blood glucose, triglyceride, and LDL compared to controls, however, no changes were observed in serum cholesterol and rat body weight.
Abstract: Objectives: Andrographis paniculata (Burm. f.) Nees originates from India and grows widely in many areas in Southeast Asian countries. Andrographis paniculata (Burm. f.) Nees has shown an antidiabetic effect in type 1 DM rats. The present study investigates the purified extract of the plant and its active compound andrographolide for antidiabetic and antihyperlipidemic effects in high-fructose-fat-fed rats, a model of type 2 DM rats. Materials and Methods: Hyperglycemia in rats was induced by high-fructose-fat diet containing 36% fructose, 15% lard, and 5% egg yolks in 0.36 g/200 gb.wt. 55 days. The rats were treated with the extract or test compound on the 50 th day. Antidiabetic activity was measured by estimating mainly the pre- and postprandial blood glucose levels and other parameters such as cholesterol, LDL, triglyceride, and body weight. Results: The purified extract and andrographolide significantly (P Conclusions: Andrographis paniculata (Burm. f.) Nees or its active compound andrographolide showed hypoglycemic and hypolipidemic effects in high-fat-fructose-fed rat.
110 citations
TL;DR: F Fourier transform infrared (FTIR) spectroscopy combined with chemometrics has been successfully used for classification and quantification of corn (CO) and sunflower oils (SFOs) in EVOO sets with high coefficient of determination and low errors, either in calibration or in validation sample sets.
Abstract: Commercially, extra virgin olive oil (EVOO) is subjected to be adulterated with low-price oils having similar color to EVOO. Fourier transform infrared (FTIR) spectroscopy combined with chemometrics has been successfully used for classification and quantification of corn (CO) and sunflower oils (SFOs) in EVOO sets. The combined frequency regions of 3027–3000, 1076–860, and 790–698 cm−1 were used for classification and quantification of CO in EVOO; meanwhile, SFO was analyzed using frequency regions of 3025–3000 and 1400–985 cm−1. Discriminant analysis can make classification of pure EVOO and EVOO adulterated with CO and SFO with no misclassification reported. The presence of CO in EVOO was determined with the aid of partial least square calibration using FTIR normal spectra. The calibration and validation errors obtained in CO's quantification are 0.404 and 1.13%, respectively. Meanwhile, the first derivative FTIR spectra and PLS calibration model were preferred for quantification of SFO in EVOO with high coefficient of determination (R2) and low errors, either in calibration or in validation sample sets.
86 citations
TL;DR: In this paper, the authors compared various energetic valorization options with each other using the simplified Life Cycle Assessment (LCA) methodology, and found that a scenario with direct gasification indicated the best environmental profile.
TL;DR: In this article, the authors investigated the mechanisms involved in surface smoothening of AISI 316L stainless steel during the surface mechanical attrition treatment (SMAT) and found that the initial surface roughness has no influence in the work hardening by the SMAT but it does slightly on the saturated roughness value obtained by this treatment.
TL;DR: Common knowledge and beliefs about antibiotic use of people in an urban area of Indonesia are examined to show that those with appropriate knowledge regarding antibiotics would also quite likely have more appropriate beliefs regarding antibiotics.
Abstract: Background
Misconceptions about antibiotic use among community members potentially lead to inappropriate use of antibiotics in the community. This population-based study was aimed at examining common knowledge and beliefs about antibiotic use of people in an urban area of Indonesia.
TL;DR: Retinal vascular parameters varied by diabetes and retinopathy status in this older Asian cohort, suggesting that subtle alterations in retinal vascular architecture are influenced by diabetes.
Abstract: Purpose: Our purpose was to examine the relationship of retinal vascular parameters with diabetes and retinopathy in an older Asian population. Methods: Retinal photographs from participants of a population-based survey of Asian Malay persons aged 40–80 years were analyzed. Specific retinal vascular parameters (tortuosity, branching angle, fractal dimension, and caliber) were measured using a semiautomated computer-based program. Diabetes was defined as random plasma glucose ≥ 11.1 mmol/liter, the use of diabetes medication, or physician-diagnosed diabetes. Retinopathy signs were graded from photographs using the modified Airlie House classification system. Results: A total of 2735 persons were included in the study. Persons with diabetes (n = 594) were more likely to have straighter (less tortuous) arterioles and wider arteriolar and venular caliber than those without diabetes (n = 2141). Among subjects with diabetes, those with retinopathy had wider venular caliber than those without retinopathy (211.3 versus 204.9 µm, p = .001). Among nondiabetic subjects, however, those with retinopathy had more tortuous venules than those without retinopathy [5.19(×10 4 ) versus 4.27(×10 4 ), p < .001].
TL;DR: In this article, the authors used discriminant analysis (DA) and multivariate calibrations of partial least square and principle component regression to analyze rice bran oil (RBO) in terms of FTIR spectra.
TL;DR: Germination represents a means to further improve the nutritional profile of the germinated ASL flour with an increased fibre and protein, but lower fat content.
Abstract: Australian Sweet Lupin (ASL) has a nutritional profile ideally suited for human consumption with high protein and fibre, but low starch and fat content. The nutritional and protein profile of germinated ASL may be better than ungerminated ASL and these improvements would provide further benefits in its use as an ingredient in food applications. In this study the nutritional components such as protein, crude fibre, fat and protein profile of germinated ASL flour following germination at 25℃ and 90% - 95% relative humidity for 9 days were determined. The changes in the pattern of ASL protein during germination were analysed using sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE). Germination significantly increased crude fibre contents by 450% (db), total protein contents by 38% (db) and decreased the fat content by 70% (db) at day 9 of germination. Electrophoretic analysis of the protein fractions revealed that during germination up to 9 days, some of the high molecular weight proteins disappeared. Germination represents a means to further improve the nutritional profile of the germinated ASL flour with an increased fibre and protein, but lower fat content.
15 Jul 2012
TL;DR: The results show that Zernike Moments have a prospect as features in leaf identification systems when they are combin ed with other features.
Abstract: So far, plant identification has challenges for sev eral researchers. Various methods and features have been proposed. However, there are still many approaches could be investigated to develop robust plant identification systems. This paper reports several experiments in using Zernike moments to build folia ge plant identification systems. In this case, Zernike moments were combined with other features: geometric features, color moments and gray-level co-occurrenc e matrix (GLCM). To implement the identifications systems, two approaches has been investigated. Firs t approach used a distance measure and the second u sed Probabilistic Neural Networks (PNN). The results sh ow that Zernike Moments have a prospect as features in leaf identification systems when they are combin ed with other features.
TL;DR: In this paper, a large travertine mound at Pancuran Pitu, Central Java, Indonesia, displays various types of lamination reflecting different hydrological conditions and geomicrobiological processes of the laminated travertines.
TL;DR: Macrophage Pdk1/Foxo1 pathway is important in regulating insulin sensitivity in vivo and regulated macrophage infiltration by inhibiting Foxo1-induced Ccr2 expression in ATM populations isolated with fluorescence-activated cell sorting.
Abstract: Chronic inflammation in adipose tissue contributes to obesity-related insulin resistance. The 3-phosphoinositide-dependent protein kinase 1 (Pdk1)/forkhead transcription factor (Foxo1) pathway is important in regulating glucose and energy homeostasis, but little is known about this pathway in adipose tissue macrophages (ATMs). To investigate this, we generated transgenic mice that carried macrophage/granulocyte-specific mutations, including a Pdk1 knockout (LysMPdk1−/−), a Pdk1 knockout with transactivation-defective Foxo1 (Δ256LysMPdk1−/−), a constitutively active nuclear (CN) Foxo1 (CNFoxo1LysM), or a transactivation-defective Foxo1 (Δ256Foxo1LysM). We analyzed glucose metabolism and gene expression in ATM populations isolated with fluorescence-activated cell sorting. The LysMPdk1−/− mice exhibited elevated M1 macrophages in adipose tissue and insulin resistance. Overexpression of transactivation-defective Foxo1 rescued these phenotypes. CNFoxo1LysM promoted transcription of the C-C motif chemokine receptor 2 (Ccr2) in ATMs and increased M1 macrophages in adipose tissue. On a high-fat diet, CNFoxo1LysM mice exhibited insulin resistance. Pdk1 deletion or Foxo1 activation in bone marrow–derived macrophages abolished insulin and interleukin-4 induction of genes involved in alternative macrophage activation. Thus, Pdk1 regulated macrophage infiltration by inhibiting Foxo1-induced Ccr2 expression. This shows that the macrophage Pdk1/Foxo1 pathway is important in regulating insulin sensitivity in vivo.
TL;DR: Integrated multicomponent and site‐specific solutions need to be developed and evaluated within a public health framework to overcome the policy–practice gap and provide functional PT programmes for children in endemic settings.
Abstract: Young children living with a tuberculosis patient are at high risk of Mycobacterium tuberculosis infection and disease WHO guidelines promote active screening and isoniazid (INH) preventive therapy (PT) for such children under 5 years, yet this well-established intervention is seldom used in endemic countries We review the literature regarding barriers to implementation of PT and find that they are multifactorial, including difficulties in screening, poor adherence, fear of increasing INH resistance and poor acceptability among primary caregivers and healthcare workers These barriers are largely resolvable, and proposed solutions such as the adoption of symptom-based screening and shorter drug regimens are discussed Integrated multicomponent and site-specific solutions need to be developed and evaluated within a public health framework to overcome the policy-practice gap and provide functional PT programmes for children in endemic settings
TL;DR: In this article, the authors assessed the use of CPH as a renewable energy source and found that the increase of carbonized CPH portion in the fuel increased the burning time of the pellet.
TL;DR: In this paper, Fourier transform infrared (FTIR) spectroscopy combined with suitable chemometrics techniques has emerged as a potential tool that allows analysts to authenticate high-value edible oils.
Abstract: In recent years, the authentication of edible fats and oils has become an important issue for food producers, consumers, and regulatory authorities due to religious and economic reasons. Some high-priced edible oils such as extra virgin olive oil (EVOO), virgin coconut oil (VCO), and cod liver oil (CLO) are adulterated with lower price oils to improve profits. These oils can be considered functional food oils due to their beneficial effects on human health. Fourier transform infrared (FTIR) spectroscopy combined with suitable chemometrics techniques has emerged as a potential tool that allows analysts to authenticate high-value edible oils. This review describes the potential use of FTIR spectroscopy for authentication of three functional food oils, namely, EVOO, VCO, and CLO.
TL;DR: The study signifies the need to account for local specificities in researching care in the South and investigates care arrangements for children in Vietnamese and Indonesian migrant families.
TL;DR: In this article, the authors investigate the implementation of performance measurement systems (PMSs) in Indonesian local government (ILG) using Smart PLS, which explores a conceptual model developed to explain the hypothesised relationships between technical and organisational factors and the development and use of performance indicators and accountability practices.
Abstract: Purpose – The purpose of this paper is to investigate the implementation of performance measurement systems (PMSs) in Indonesian local government (ILG) using Smart PLS. Couched within an institutional theory framework, it explores a conceptual model developed to explain the hypothesised relationships between technical and organisational factors and the development and use of performance indicators and accountability practices.Design/methodology/approach – Surveys were sent to senior finance officers in all local governments (457) across Indonesia with a response rate of 21.4 percent being achieved. Smart PLS was used to assess the quality of the data and analyse the research model proposed.Findings – Findings revealed that ILGs developed performance indicators more to fulfil regulatory requirements than to make their organisation more effective and efficient. As a way of increasing the success of PMS implementation management commitment through good leadership was found to be a major contributor. Coercive...
01 Jan 2012
TL;DR: In this article, the authors used the Big Five Personality Inventory (BFI) to predict consumptive behavior, entrepreneurship interest, customer satisfaction and organizational commitment in the Indonesian language and tested the Indonesian-version of BFI to 790 people with different backgrounds of age, education and places of origin.
Abstract: The use of Big Five Personality taxonomy in psychology research gradually is getting more and more popular. The Big Five Personality Inventory (BFI) is utilized to predict consumptive behavior, entrepreneurship interest, customer satisfaction and organizational commitment. Some use the term Big Five Inventory and some use Five Factor Model. The items also vary in number. It may consist of 44 items, 50 items, 100 items, or even 300 items. The research aiming to adapt the Big Five Inventory into Indonesian language was conducted in two stages. The first consisted of a process of translating Oliver John’s Big Five Personality Scale of 44-item version and discussing the translation result. This stage was done by two Indonesian people with background of psychology who had lived in United States of America for more than five years. The discussion was mediated by a psychologist who earned Ph.D. in the US. The agreed translation result was retranslated into English by a professional translator who had no background of psychology. The result of this re-translation was then compared to the original BFI to see the similarity in meaning. The re-translation result indicated no differences in meaning compared to the original BFI. Subsequently, the BFI of Indonesian version was read by three lay-people in order to find out whether the translated items can be understood consistent with their meanings of its original source. The second stage was to test the Indonesian-version BFI to 790 people with different backgrounds of age, education and places of origin. Result of the first stage was presented in the format of a description of translation process. The second stage, which was a confirmatory factor analysis (CFA) resulted in two measuring models, namely M2 and M3. The M2 model consisted of 37 items whose quality was good enough, showing the score of λ ranging between 0.32 and 0.78 and the reliability α between 0.70 and 0.79. The M3 models consisted of 28 items with good quality, showing the score of λ between 0.43 and 0.80 and its reliability α between 0.70 and 0.79. In conclusion, items with lower loading factor indicate that sentences of the BFI translation must be corrected in the next research.
TL;DR: There were minimal variations in the CRAE, CRVE, tortuosity, and branching angle that are clinically used for two-dimensional measures of retinal vascular geometry during cardiac cycles, however, there was significant variation in the caliber of the individual vessels over the cardiac cycle.
Abstract: Purpose. Changes in retinal vascular parameters have been shown to be associated with systemic vascular diseases. In this study, we assessed the physiologic variations in retinal vascular measurements during the cardiac cycle. Methods. Fundus images were taken using electrocardiogram-synchronized retinal camera at nine distinct cardiac points from 15 healthy volunteers (135 images). Analyses of retinal vessel geometric measures, including retinal vessel caliber (individual and summary), tortuosity, branching angle, length-diameter ratio (LDR), and optimality deviation, were performed using semiautomated computer software. Repeated-measures ANOVAs were used to obtain the means and to estimate the variation of each cardiac point compared with cardiac point 1. Results. There was a significant variation of the caliber of the individual arteriolar and venular vessels. However, there was no significant variation found for vessel caliber summary, represented by the central retinal arteriolar equivalent (CRAE) and the central retinal venular equivalent (CRVE). There was also no significant variation found for tortuosity and branching angle, and LDR showed none or very little variations at different cardiac points: variations in caliber ranges between 0 and 4.1%, tortuosity 0 and 1.5%, branching angle 0 and 3.5%, and LDR 0 and 2%; all values for variations, P > 0.1; linear trend, P > 0.5; and nonlinear trend, P > 0.8. Conclusions. This study showed that there were minimal variations in the CRAE, CRVE, tortuosity, and branching angle that are clinically used for two-dimensional measures of retinal vascular geometry during cardiac cycles. However, there was significant variation in the caliber of the individual vessels over the cardiac cycle.
TL;DR: In persons with diabetes, eyes with longer ALs are less likely to have diabetic retinopathy and DME and no association was found for SE, ACD, and CC with DR.
TL;DR: It is found that Ro52(low) HeLa cells were significantly more resistant to apoptosis than wild-type He La cells when stimulated by H(2)O(2)- or diamide-induced oxidative stress, IFN-α, IFn-γ and anti-Fas antibody, etoposide, or γ-irradiation.
TL;DR: These results strengthen the previous observation that tobacco smoking is an important risk factor of NPC in this population and suggest that this locus is involved in NPC susceptibility, representing a novel finding in NPC epidemiology.
Abstract: Background
The incidence of nasopharyngeal carcinoma (NPC) varies substantially worldwide, with an endemic pocket in Southeast Asia.
TL;DR: In this paper, the relationship between retinal vascular geometry parameters and development of incident renal dysfunction in young people with type 1 diabetes was examined in a prospective cohort study of 511 adolescents with at least 2 years duration, with normal albumin excretion rate (AER) and no retinopathy at baseline.
Abstract: OBJECTIVE To examine the relationship between retinal vascular geometry parameters and development of incident renal dysfunction in young people with type 1 diabetes. RESEARCH DESIGN AND METHODS This was a prospective cohort study of 511 adolescents with type 1 diabetes of at least 2 years duration, with normal albumin excretion rate (AER) and no retinopathy at baseline while attending an Australian tertiary-care hospital. AER was quantified using three overnight, timed urine specimen collections and early renal dysfunction was defined as AER >7.5 μg/min. Retinal vascular geometry (including length-to-diameter ratio [LDR] and simple tortuosity [ST]) was quantified from baseline retinal photographs. Generalized estimating equations were used to examine the relationship between incident renal dysfunction and baseline venular LDR and ST, adjusting for age, diabetes duration, glycated hemoglobin (A1C), blood pressure (BP), BMI, and cholesterol. RESULTS Diabetes duration at baseline was 4.8 (IQR 3.3–7.5) years. After a median 3.7 (2.3–5.7) years follow-up, 34% of participants developed incident renal dysfunction. In multivariate analysis, higher retinal venular LDR (odds ratio 1.7, 95% CI 1.2–2.4; quartile 4 vs. 1–3) and lower venular ST (1.6, 1.1–2.2; quartile 1 vs. 2–4) predicted incident renal dysfunction. CONCLUSIONS Retinal venular geometry independently predicted incident renal dysfunction in young people with type 1 diabetes. These noninvasive retinal measures may help to elucidate early mechanistic pathways for microvascular complications. Retinal venular geometry may be a useful tool to identify individuals at high risk of renal disease early in the course of diabetes.