Differential associations between body mass index with diabetes and vision-threatening diabetic retinopathy in an adult Chinese population

Abstract

PurposeTo investigate the associations between body mass index (BMI) with diabetes mellitus (DM) and vision-threatening diabetic retinopathy (VTDR).MethodsThis was a longitudinal study which included DM-free participants aged ≥40 years from the Lingtou Eye Cohort Study at baseline (2008–2010). Physical and ocular examinations were performed at baseline and annual follow-ups under standardised protocol. Two 45° non-mydriatic colour digital retinal photographs were obtained for each eye at all study visits, and presence of VTDR at the 2016 follow-up was graded by a deep-learning algorithm (LableMe) with proved high accuracy for detection of VTDR.ResultsA total of 2934 participants were included with a mean (SD) age of 59.5 (7.3) years (58.3% men). Participants with incident DM (441/2934, 15%) were significantly older (p<0.001), had higher obesity levels (p<0.001), higher systolic blood pressure (SBP) (p<0.001), diastolic blood pressure (p<0.001), fasting plasma glucose (FPG) (p<0.001), triglycerides (p=0.002) and high-density lipoprotein cholesterol (p<0.001), as compared with those without. Participants with incident VTDR (48/2934, 1.63%) were also older (p<0.001), had higher SBP (p=0.013) and FPG (p<0.001), but did not differ in baseline BMI, comparing with those without. Regression analysis showed that higher baseline BMI was significantly related to incident DM (p<0.005), but not incident VTDR, during the follow-up. Subgroup analysis among participants with incident DM also revealed no association between BMI and VTDR.ConclusionsHigher baseline BMI increased the risk of incident DM, but was not related to the risk of VTDR in this adult Chinese population.

Biscuit consumption and diabetic retinopathy incidence in adults in the United States

“…Hypertension would cause increased retinal blood flow and lead to retinal hyperperfusion, a critical source of injury in DR associated with shearing damage to capillaries. The effect of elevated BMI on DR might be through irregulated blood viscosity, platelet function, oxidative stress and retinal inflammation[ 28 ].…”

“…[ 17 , 26 , 28 ]It is well known that dietary intake have a great impact on the risk of several chronic diseases, including DM and obesity [ 29 ]. Therefore, it is essential to investigate the potential correlation between food consumption and health outcomes.…”

Development and evaluation of a risk prediction model for diabetes mellitus type 2 patients with vision-threatening diabetic retinopathy

“…Previous studies have found a possible neutral association between BMI and DR, indicating the existence of both protective and adverse effects ( 25 ). Han and X’s study showed that a higher BMI increased the risk of developing diabetes but was not related to VTDR ( 26 ). However, a large-scale epidemiological study conducted in India in 2022 demonstrated no relationship between BMI and DR, but it did reveal a negative correlation between BMI and VTDR ( 11 ).…”