Risk factors for diabetic retinopathy: a case–control study

Abstract

BackgroundDiabetic retinopathy (DR) is the major cause of blindness among working age adults. The aim of the study was to investigate risk factors for development of DR.MethodsA case–control study was performed based on data from 240 individuals (80 cases and 160 controls) attending the Outpatient Specialty Clinic of the University of South Santa Catarina (UNISUL), between Mar/2010 and May/2014. Data collection occurred through review of medical charts for presence or absence of DR, determined by an ophthalmologist. Study protocol included demographic characteristics, metabolic control, diabetes mellitus (DM) profile and comorbidities. Statistical analysis used Chi square test for qualitative variables and multivariate logistic regression analysis to select independent variables (SPSS®18.0 software). Odds ratio (OR) was used as measure of association. The study was approved by research ethics committee of UNISUL.ResultsMean age of group case was 59.5 years with a slight female predominance. Gender, age, body mass index were not associated with outcome. Individuals with poor glycemic control were more likely to DR (OR 3.83; 95 % CI 1.57–9.37). It was observed a positive relationship between duration of DM and DR, with higher chances in 11–15 years of disease (OR 7.52, 95 % CI 3.03–18.68) and >15 years (OR 9.01, 95 % CI 3.58–22.66). Regarding comorbidities, only diabetic nephropathy showed higher chance for DR (OR 3.32; 95 % CI 1.62–6.79).ConclusionsDiabetic patients after 10 years of disease with poor glycemic control and nephropathy have a higher chance of DR.

Elevation in Circulating Soluble CD40 Ligand Concentrations in Type 2 Diabetic Retinopathy and Association with its Severity

“…DWR and DR patients were matched according to age, BMI, and lipid profile, thereby ruling out the contribution of obesity [11] or lipotoxicity [33,34] to DR. In addition, significant differences between both T2DM patient groups were seen in the age of onset and duration of diabetes, and HbA1c, confirming the role of long exposure to hyperglycemia and poor glycemic control to DR [24,[34][35][36]. This appears to influence DR severity, as higher sCD40L levels were seen in PDR more so than NPDR patients, which is likely attributed to hyperglycemia and insulin resistance (HOMA-IR) [18].…”

“…Insofar as sCD40L levels are generally elevated in obesity [29,30], our findings indicate that sCD40L levels did not correlate with BMI in DR patients, as well as NPDR and PDR groups. This suggests that the increases in sCD40L levels in DR patients are the result of impaired glucose tolerance associated with inflammatory changes [24,31,32], independent of obesity. DWR and DR patients were matched according to age, BMI, and lipid profile, thereby ruling out the contribution of obesity [11] or lipotoxicity [33,34] to DR.…”

“…The contribution of changes in plasma sCD40L and diabetes complications was previously reported, but with inconsistent findings. While increased sCD40L levels were seen in type 1 diabetes (T1DM) [23] and T2DM [24] patients with CVD complications, T2DM patients without overt CVD did not present with significant changes in sCD40L levels [23]. This prompts the speculation as to the extent to which overt CVD itself influences the changes in circulating sCD40L levels.…”

Fatores de risco para retinopatia diabética: uma revisão

“…Garcia et al (2003); Pérez et al (2011). Moreno et al (2013); ACP (1999); Boelter et el (2003); DCCT Research Group (2005); Bosco et al (2005); ACP (1999); Lima et al (2016). Nefropatia diabética Klein et al (1984); Boelter (2003); Reggi et al (2001).…”

Bmi Basal Metabolic Index and Retinopathy in Type 2 Diabetics.

“…11 Some studies reported the higher incidence of DR with obesity. 12,13 While some studies observed a decreased incidence of DR in higher BMI individuals 14,15 and still few other studies noticed an insignificant association between obesity and the occurrence of DR. 16 In order to find the trend in local population we explored the comparison and correlation in type two diabetics with and without diabetic retinopathy.…”