Retinopathy in a Chinese population with type 2 diabetes: factors affecting the presence of this complication at diagnosis of diabetes

Liu, D.P.; Molyneaux, Lynda; Chua, Elizabeth L.; Wang, Y.Z.; Wu, Cheng; Jing, Haoyu; Hu, Liangbo; Liu, Y.J.; Zhang, Xu; Yue, Du

doi:10.1016/s0168-8227(01)00349-7

Cited by 47 publications

(34 citation statements)

References 11 publications

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“…To our knowledge, this is the first study that has evaluated the association between VLDLC and DR and found a statistically significant association. The significant association of hyperlipidemia with DR in our study is consistent with the findings from the recent Beijing Communities Diabetes Study , which reported that higher total cholesterol (P=0.003) and higher LDLC (P=0.007) were significantly associated with increased risk of DR. Our findings are also consistent with a few other studies of Chinese populations (Table 4), which reported significant or marginally significant associations between total cholesterol levels and DR (Liu et al, 2002;Cai et al, 2006;Wang F.H. et al, 2011;Wang S. et al, 2012).…”

Section: Discussionsupporting

confidence: 93%

“…et al, 2011). The Beijing 301 Hospital study also found a marginally significant association between total cholesterol levels and DR (P=0.054) (Liu et al, 2002). The Beijing eye study reported a marginally significant association between HDLC levels and DR (OR=1.96, 95% CI 0.92-4.21, P=0.08 from multivariate analysis) and a higher risk of DR in patients with dyslipidemia (OR=1.34, 95% CI 0.93-1.93) although that association was not statistically significant (P=0.12) .…”

Section: Discussionmentioning

confidence: 91%

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Serum lipids and other risk factors for diabetic retinopathy in Chinese type 2 diabetic patients

Zhang

Wang

Ying

et al. 2013

J. Zhejiang Univ. Sci. B

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Abstract:Objective: To investigate the association of serum lipids and other risk factors with diabetic retinopathy (DR) in Chinese type 2 diabetic patients. Methods: Five hundred and twenty-three type 2 diabetic patients underwent ophthalmic examination by experienced retinal specialists to assess their DR. Serum lipids, including triglycerides, total cholesterol, high density lipoprotein cholesterol (HDLC), and low density lipoprotein cholesterol (LDLC), were measured using Roche automated clinical chemistry analyzers. The concentration of very low density lipoprotein cholesterol (VLDLC) was calculated based on total cholesterol, HDLC and LDLC. Hyperlipidemia was defined as a total cholesterol concentration of 6.2 mmol/L or higher or the use of lipid-lowering medications. The association of risk factors with any DR or proliferative diabetic retinopathy (PDR) was assessed using the odds ratio (OR) and its 95% confidence interval (CI), calculated from logistic regression models. Results: In multivariate logistic regression models, hyperlipidemia (OR=2.39, 95% CI: 1.02-5.66), higher VLDLC (OR=1.59, 95% CI: 1.14-2.23), and higher triglyceride (OR=1.18, 95% CI: 1.03-1.37) were associated with increased risk of DR. A longer diabetic duration was associated with increased risk of DR (P<0.0001) and PDR (P=0.002) in a dose-response manner. Higher systolic blood pressure (P=0.02) and higher serum creatinine (P=0.01) were independently associated with increased risk of DR, and female gender was associated with increased risk of PDR (P=0.03). Conclusions: Among Chinese type 2 diabetic patients, hyperlipidemia, higher VLDLC, and higher triglyceride were independently associated with increased risk of DR, suggesting control of serum lipids may decrease the risk of DR.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 91%

Serum lipids and other risk factors for diabetic retinopathy in Chinese type 2 diabetic patients

Zhang

Wang

Ying

et al. 2013

J. Zhejiang Univ. Sci. B

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“…Both proteinuria and macroalbuminuria have been related to the development of DR in type 2 DM (5,6,18). In the present study, an AER >100 µg/min was strongly associated with the presence of DR, providing further evidence that once a complication has been established, glycemic control can be fundamental in delaying or avoiding the onset of other complications.…”

Section: Kg Santos Et Alsupporting

confidence: 67%

“…Duration of diabetes and hyperglycemia are two well-known risk factors for the development of DR (1)(2)(3)6,7,(14)(15)(16)(17). In our study, patients with retinopathy had a longer duration of diabetes and more severe diabetes than patients without it, as indicated by a lower body mass index, a higher frequency of insulin therapy, higher HbA 1 levels, lower C-peptide levels, and a higher AER.…”

Section: Kg Santos Et Alsupporting

confidence: 46%

Prevalence of retinopathy in Caucasian type 2 diabetic patients from the South of Brazil and relationship with clinical and metabolic factors

Santos

Tschiedel

Schneider

et al. 2005

Braz J Med Biol Res

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Diabetic retinopathy (DR) is a sight-threatening chronic complication of diabetes mellitus and is the leading cause of acquired blindness in adults. In this cross-sectional study, we investigated the prevalence of and the factors associated with DR in an analysis of 210 consecutive and unrelated Brazilian Caucasians with type 2 diabetes mellitus. Retinopathy was evaluated by ophthalmoscopy and/or biomicroscopy through dilated pupils. The relationship between clinical and metabolic variables and the presence of DR was assessed by logistic regression analysis. DR was detected in 99 of the 210 patients (47%). In the univariate logistic regression analyses, male sex, duration of diabetes, body mass index, glycated hemoglobin, C-peptide, LDL cholesterol, smoking, and albumin excretion rate were found to be associated with the presence of DR. However, the multiple logistic regression analysis showed that only duration of diabetes (odds ratio (OR) = 1.15, 95% CI = 1.09-1.22; P < 0.001), glycated hemoglobin (OR = 1.21, 95% CI = 1.01-1.46; P = 0.047) and albumin excretion rate >100 µg/min (OR = 12.72, 95% CI = 3.89-41.56; P < 0.001) were independently associated with DR. Although DR was found to be frequent among Brazilian type 2 diabetic patients, its prevalence was within the range observed in other Caucasian populations. Our findings emphasize the need for good glycemic control in order to prevent or delay the onset of DR, since the most well-known risk factors for the development of this complication in type 2 diabetes mellitus, such as duration of diabetes, glycated hemoglobin and albumin excretion rate were independently related to DR.

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“…Finally, the lower prevalence of retinopathy in the MESA may be related to the use of 45 degree nonstereoscopic, nonmydriatic photographs to grade retinopathy. 35 In other studies, 3-5 such as in the WESDR, 3 retinopathy was detected by grading of seven stereoscopic fundus photographs. In a pilot study of 72 eyes of 36 subjects with diabetes, retinopathy lesions were detected more frequently from seven stereoscopic film photographs than from nonstereoscopic, nonmydriatic digital photographs (Moss SE, ARVO Meeting, 2004, abstract).…”

Section: Discussionmentioning

confidence: 95%

Diabetic Retinopathy in a Multi-ethnic Cohort in the United States

Wong

Klein

Islam

et al. 2006

American Journal of Ophthalmology

589

437

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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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Retinopathy in a Chinese population with type 2 diabetes: factors affecting the presence of this complication at diagnosis of diabetes

Cited by 47 publications

References 11 publications

Serum lipids and other risk factors for diabetic retinopathy in Chinese type 2 diabetic patients

Serum lipids and other risk factors for diabetic retinopathy in Chinese type 2 diabetic patients

Prevalence of retinopathy in Caucasian type 2 diabetic patients from the South of Brazil and relationship with clinical and metabolic factors

Diabetic Retinopathy in a Multi-ethnic Cohort in the United States

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