Retinal arteriolar and venular caliber is associated with a range of cardiovascular risk factors, including hypertension, diabetes, measures of obesity, and dyslipidemia. Venular caliber is also associated with systemic inflammation.

PURPOSE-To describe the prevalence and risk factors of diabetic retinopathy in a multi-ethnic US population of whites, blacks, hispanics, and chinese. DESIGN-Cross-sectional study of 778 individuals from ages 45 to 85 years with diabetes, participating in the Multi-Ethnic Study of Atherosclerosis (MESA).METHODS-Retinal photographs were obtained with a 45° nonmydriatic digital fundus camera. Presence and severity of diabetic retinopathy were graded at a central reading center on the basis of a modification of the Airlie House classification system. All participants underwent a standardized interview, examination, and laboratory investigations.RESULTS-In this population with diabetes, the prevalence of any retinopathy was 33.2% and macular edema 9.0%. The prevalence of any diabetic retinopathy and macular edema was significantly higher in blacks (36.7% and 11.1%) and hispanics (37.4% and 10.7%) than in whites (24.8% and 2.7%) and chinese (25.7% and 8.9%) (P = .01 and P = .007, comparing racial/ethnic differences for retinopathy and macular edema, respectively). Significant independent predictors of any retinopathy were longer duration of diabetes, higher fasting serum glucose, use of diabetic oral medication or insulin, and greater waist-hip ratio. Race was not an independent predictor of any retinopathy.CONCLUSIONS-This study provides contemporary data on the prevalence of and risk factors for diabetic retinopathy among whites, blacks, hispanics, and chinese participating in the MESA.Diabetic retinopathy, the most common specific complication of type 2 diabetes, is the leading cause of blindness among Americans age 20 to 64 years. 1,2 The epidemiology of diabetic retinopathy has been previously described, largely in white populations. 3-6 In the Wisconsin Epidemiological Study of Diabetic Retinopathy (WESDR), the prevalence of retinopathy in 1980 to 1982 among persons with type 2 diabetes was reported at 39% for those not receiving insulin treatment, and 70% for those receiving insulin treatment. 3 A recent review of data In contrast to whites, there are fewer population-based data on either the prevalence of or the risk factors for retinopathy in other racial/ethnic groups with diabetes in the United States. 17-20 Because diabetes prevalence appears to vary between these racial/ethnic groups, 21-23 it has been suggested that the frequency of retinopathy may also vary by race/ethnicity. The few studies conducted suggest that in comparison to studies in whites, African Americans (blacks) and hispanics have a higher prevalence of retinopathy. 24-26 These differences have been attributed in part to racial/ethnic differences in diabetes duration, glycemic control, and blood pressure levels in blacks, but not in hispanics. There are no data on the epidemiology of diabetic retinopathy in Chinese Americans (chinese).The purposes of our current study were to describe the prevalence of diabetic retinopathy among whites, blacks, hispanics, and chinese diagnosed with diabetes participating in the Multi-Ethnic Study ...

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