Body Mass Index: A Risk Factor for Retinopathy in Type 2 Diabetic Patients

Abstract

The aim of the study was to investigate whether body mass index (BMI) independently or in correlation with other risk factors is associated with diabetic retinopathy (DR) progression. The study included 545 patients with type 2 diabetes. According to DR status, they were divided into three groups: group 1 (no retinopathy; n = 296), group 2 (mild/moderate nonproliferative DR; n = 118), and group 3 (severe/very severe NPDR or proliferative DR; n = 131). Patients without DR were younger than those with signs of retinopathy at time of diabetes onset whilst diabetes duration was longer in groups with severe NPDR and PDR. DR progression was correlated with diabetes duration, BMI, HbA1c, hypertension, and cholesterol. Statistical analyses showed that the progression of retinopathy increased significantly with higher BMI (gr. 1: 26.50 ± 2.70, gr. 2: 28.11 ± 3.00, gr. 3: 28.69 ± 2.50; P < 0.01). We observed a significant deterioration of HbA1c and a significant increase in cholesterol and hypertension with an increase in BMI. Correlation between BMI and triglycerides was not significant. Thus, BMI in correlation with HbA1c cholesterol and hypertension appears to be associated with the progression of DR in type 2 diabetes and may serve as a predictive factor for the development of this important cause of visual loss in developed countries.

Diabetic Retinopathy and Sex Hormones

“…Progression of DR was associated with higher diastolic blood pressure at baseline and increases in diastolic blood pressure over 4 years of follow up [3]. 3.…”

“…Intensive glycemic control and decreasing the level of glycosylated haemoglobin, (HbA1c) is the most effective in delaying the progression of DR [3]. 2.…”

“…3. Nephropathy: Wisconsin Epidemiological study of diabetic retinopathy (WESDR) study predicted about 95% increased risk of developing Diabetic Macular Edema in the presence of gross proteinuria ( defined as microalbuminuria when there is an excretion of less than or equal to 300mg/dL/day and macroalbuminuria at greater than 300mg/dL/day) at baseline [3]. 4.…”

“…4. Hyperlipidemia: Early Treatment Diabetic Retinopathy Study (ETDRS) concluded that there is significant correlation between elevated cholesterol, high density lipids and triglycerides with faster development of hard exudates [3]. 5.…”

“…5. Anemia: A diabetic patient with less than 12 g/dl of haemoglobin has two fold increased risk of any grade of retinopathy and fivefold increase risk of developing severe grade of retinopathy in already established DR [3]. 6.…”