Ocular and systemic factors associated with diabetes mellitus in the adult population in rural and urban China. The Beijing Eye Study

Abstract

Purpose To assess ocular and systemic factors associated with diabetes mellitus in the adult population in rural and urban China. Methods The Beijing Eye Study 2006, a population-based, cross-sectional cohort study, included 3251 subjects aged 45 years and more (participation rate: 73.2%). Blood samples were available for 2960 (91.0%) subjects. Diabetes mellitus was defined by a fasting plasma glucose concentration Z7.0 mmol/l or by a self-reported history diagnosis of diabetes. Results Diabetes mellitus was found in 381 (12.9%) subjects. In binary regression analysis, the presence of diabetes mellitus was significantly associated with body mass index, systolic blood pressure, triglyceride concentrations, intraocular pressure, cylindrical refractive dioptre, presence of arteriolar sheathing, rural vs urban region, lower best-corrected visual acuity, lower highdensity lipoprotein level, and lower diastolic blood pressure. It was not statistically associated with age, presence of cataract (nuclear, cortical, or subcapsular), size of the optic disc, neuroretinal rim, a zone and b zone of peripapillary atrophy, retinal artery and vein diameters, arteriovenous nicking, focal or general narrowing, refractive error, prevalence of glaucoma, and early or late stage of agerelated macular degeneration.Conclusions In a population-based setting, diabetes mellitus was not associated with optic disc, rim and peripapillary atrophy measurements, retinal vessel diameters, arteriovenous nicking, focal or general retinal artery narrowing, and prevalence of age-related macular degeneration. Although diabetes mellitus was significantly correlated with higher intraocular pressure, it was not associated with glaucoma.

Diabetes Mellitus and Risk of Age-Related Macular Degeneration: A Systematic Review and Meta-Analysis

“…In addition, to provide a better understanding in diabetes as an independent risk factor for AMD, fourteen studies that presented diabetes as a covariate and provided ORs/RRs/HRs from baseline data without any adjustment were excluded, involving 12 cross-sectional [11], [15], [17], [28], [29], [30], [31], [32], [33], [34], [35], [36] and 2 case-control studies [37], [38]. The 24 articles included 1858350 participants in 27 independent study populations, comprising 7 cohort studies [39], [40], [41], [42], [43], 9 cross-sectional studies [9], [14], [16], [44], [45], [46], [47], [48], and 11 case-control studies [12], [13], [36], [49], [50], [51], [52], [53], [54], [55], [56]. Among the 27 study populations, 10 were in Asia, 9 in North America (United States), 6 in Europe, 1 in Oceania (Australia), and 1 in South America (Barbados).…”

“…Similar findings were revealed by subgroup analyses involving cross-sectional and case-control studies. In the analysis of cross-sectional studies, the removal of studies by Vaičaitienė et al [14], Duan et al [45], Xu et al [16], and Choi et al [47] would also lead to borderline results (removing study by Vaičaitienė et al: OR, 1.10; 95% CI, 0.98–1.23; Duan et al: OR, 1.30; 95% CI, 0.97–1.73; Xu et al: OR, 1.21; 95% CI, 0.99–1.47; Choi et al: OR, 1.16; 95% CI, 0.96–1.41). In addition, in the subgroup analysis of case-control studies, an association of borderline significance between diabetes and AMD (OR, 1.23; 95% CI, 0.97–1.56) was presented if the study by Nitsch et al [13] was excluded.…”

“…As a modifiable personal factor, whether diabetes play a role in the development and progression of AMD has been vigorously studied. While several reports presented positive correlations between diabetes and AMD [9], [10], [11], [12], [13], [14], some other reports showed no such effect [15], [16]. Even inversed relationship has been reported [17].…”

Vascular Dysfunction in Diabetes and Glaucoma

“…However, despite its correlation with increased IOP, diabetes was not found to be associated with glaucoma. 22 Other studies have even proposed that diabetes may be protective against OAG. For instance, Quigley 26 theorizes that as diabetes leads to impaired retinal vascular function, consequential ischemia and neuronal death may serve as stimuli that precondition the tissue to OAG, which has been shown to upregulate neuronal survival pathways in the retinal ganglion cells.…”

“…22,23 The Singapore Malay Eye Study investigated the relationship between diabetes and metabolic abnormalities with IOP and glaucoma. This was a population-based study consisting of 3280 Malay adults ranging from 40 to 80 years old.…”