Abstract
Background: The aim of this study is to examine the association of physical activities (PA) with DR progression based on 10 years follow-up on a large cohort of working-age diabetic patients in Australia. Methods: Nine thousand and eighteen working-age diabetic patients were enrolled from the baseline of the 45 and Up Study from New South Wales, Australia. Self-reported PA collected by questionnaire at baseline in 2006 was graded into low (<5 sessions/week), medium (≥5-14), and high (≥14) levels. Retinal photocoagulation (RPC) treatment during the follow-up period was used as a surrogate for DR progression and was tracked through Medicare Benefits Schedule, which is available from 2004 to 2016. Cox regression was used to estimate the association between PA and RPC incidence. Findings: In the fully adjusted model, higher PA level was significantly associated with a lower risk of RPC incident (Cox-regression, p-value for trend=0·002; medium vs. low, HR=0·78, 95%CI: 0·61-0·98; high vs. low, HR=0·61, 95%CI: 0·36-0·84). In addition, gender, body mass index, insulin treatment, family history of diabetes, history of cardiovascular disease were significant effect modifiers for the association between PA and RPC. Interpretation: Higher PA level was independently associated with a lower risk of DR progression in working-age diabetic patients. Funding: Professor Mingguang He receives support from the University of Melbourne at Research Accelerator Program and the CERA Foundation. The Centre for Eye Research Australia (CERA) receives Operational Infrastructure Support from the Victorian State Government. The specific project is funded by Australia China Research Accelerator Program at CERA. Professor Mingguang He is also supported by the Fundamental Research Funds of the State Key Laboratory in Ophthalmology, National Natural Science Foundation of China (81420108008). The sponsor or funding organization had no role in the design or conduct of this research. Declaration of Interest: The authors have no financial or other conflicts of interest concerning this study. Ethical Approval: Ethics approval of the 45 and Up Study was obtained from the University of NSW Human Research Ethics Committee. Approval to use data from the 45 and Up Study for the current study was received from the Center for Eye Research Australia Ethics Committee.
Highlights
Diabetes has become a public health burden worldwide, with an estimated prevalence of 9% by 2040 [1]
In the fully adjusted model, higher Physical activity (PA) level was significantly associated with a lower risk of Retinal photocoagulation (RPC) incident (Cox-regression, p-value for trend = 0.002; medium vs. low, hazard ratio (HR) = 0.78, 95% Confidence Interval (CI): 0.61–0.98; high vs. low, HR = 0.61, 95%confidence Interval (CI): 0.36– 0.84
Higher PA level was independently associated with a lower risk of diabetic retinopathy (DR) progression among working-aged diabetic populations in this large cohort study
Summary
Diabetes has become a public health burden worldwide, with an estimated prevalence of 9% (accumulated 642 million patients) by 2040 [1]. There are about 100 million DR patients worldwide, and one third suffer vision-threatening DR [3] These numbers are projected to grow in the following decades with the increasing diabetes populations, resulting in a tremendous burden on the economic and health system. Studies conducted in type 2 diabetic patients found that higher levels of PA were associated with milder DR and less likelihood of DR onset; these studies were cross-sectional in design or limited by small sample size [6,7,8]. There is only one longitudinal study recently published, reporting a lower DR incidence in participants with higher PA levels, but this study was conducted in a small sample of the cohort during 2-year follow-up [9]. To the best of our knowledge, the longitudinal relationship between PA and progression to a vision-threatening stage of DR has not been reported
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
