Abstract
Purpose: This study determined the relative importance of risk factors for Diabetic Retinopathy (DR) and Diabetic Macular Edema (DME) and assessed their independent and joint contributions. Methods: A prospective study of patients with type 2 diabetes was conducted in a tertiary eye hospital in Melbourne, Australia. Patients underwent a comprehensive eye examination and completed standardized administered questionnaires. Blood samples were assessed for glycated haemoglobin (HbA1c); fasting blood glucose; and serum lipids. Dilated fundus photographs were obtained and graded for DR and DME. The relative importance of the risk factors was determined by the independent and common variance explained in DR and DME using Commonality analysis. Results: A total of 497 patients with type 2 diabetes were included in this analysis. The key risk factors accounted for 44.6% and 19.5% of total variances in DR and DME, respectively. The most important risk factor for any DR was duration of diabetes (16.5% of total explained variance), followed by insulin use (13.1%), HbA1c (8.5%), age (3.7%) and gender (2.8%). The most important risk factor for any DME was HbA1c (9.45%); followed by age (5.75%); duration of diabetes (3.92%) and systolic blood pressure (SBP) (0.36%). Sixty-one percent of the total explained variance in DR was due to common variance among these risk factors, compared to only 31% of the in DME. Conclusion: The total, independent and joint contributions of the key risk factors for DR and DME differ in patients with type 2 diabetes, which suggest that may require specific prevention and intervention strategies for these two diabetic complications.
Highlights
Diabetic retinopathy (DR) and diabetic macular edema (DME) are common complication of diabetes and the leading causes of blindness in the working-age population worldwide [1,2,3]
The results obtained from hierarchical regression analysis can be influenced by the order of variables entered into the equation
There was no difference between the two groups in educational attainment, income, DBP, body mass index (BMI), LDL-C, and triglycerides
Summary
Diabetic retinopathy (DR) and diabetic macular edema (DME) are common complication of diabetes and the leading causes of blindness in the working-age population worldwide [1,2,3]. Most previous studies assessing the association between these major risk factors and DR/DME use traditional regression methods (e.g., logistic regression models), which do not fully explain the amount of variation in DR/ DME, partly due to the non-inclusion of shared or common variations among the risk factors [5,6,7,8,9,10]. Other methods, such as hierarchical regression analysis, have been used to determine the amount of variance in the dependent variable that is explained by the independent variable(s). The results obtained from hierarchical regression analysis can be influenced by the order of variables entered into the equation
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
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 call
