Abstract

Diabetic retinopathy (DR) is one of the main causes of visual loss in individuals aged 20–64 years old. The aim of this study was to investigate, in a multicenter retrospective cross-sectional study, sex-gender difference in DR in a large sample of type 2 diabetic patients (T2DM). 20,611 T2DM regularly attending the units for the last three years were classified as having: (a) No DR (NDR), (b) nonproliferative DR (NPDR), or (c) preproliferative/proliferative DR (PPDR). DR of all grades was present in 4294 T2DM (20.8%), with a significant higher prevalence in men as compared to women (22.0% vs. 19.3% p < 0.0001). Among DR patients, both NPDR and PPDR were significantly more prevalent in men vs. women (p = 0.001 and p = 0.0016, respectively). Women had similar age and BMI, but longer diabetes duration, worse glycemic metabolic control, and more prevalence of hypertension and chronic renal failure (CRF) of any grade vs. men. No significant differences between sexes were evident in term of drug therapy for diabetes and associate pathologies. Conclusions: In this large sample of T2DM, men show higher prevalence of DR vs. women, in spite of less represented risk factors, suggesting that male sex per se might be a risk factor for DR development.

Highlights

  • Diabetic retinopathy (DR) is one of the main causes of visual loss in diabetic subjects of age between 20 and 64 years [1]

  • Diagnosis of type 2 diabetes was done according to the presence of fasting blood glucose more than 126 mg/dL, glycated hemoglobin more than 6.5%, or blood glucose more than 200 mg/dL at 1200 of an 75 g Oral

  • In set 1 (7704 men and 5563 women), DR of any grade was significantly more represented in men

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Summary

Introduction

Diabetic retinopathy (DR) is one of the main causes of visual loss in diabetic subjects of age between 20 and 64 years [1]. Diabetic retinopathy can be classified as nonproliferative (NPDR), usually mild where the walls of the blood vessels in the retina weaken with tiny bulges (microaneurysms) protruding from the vessel walls of the smaller vessels, sometimes leaking fluid and blood into the retina far away from the macula. NPDR can progress to a more severe type, sometimes termed preproliferative, characterized by leaking fluid and/or blood closely to the macula, which is a prelude to the more advanced form of proliferative diabetic retinopathy. In proliferative diabetic retinopathy, damaged blood vessels close off, causing the growth of new, abnormal blood vessels in the retina, and can leak into the clear vitreous, possibly ending in visual loss [1]. Higher HBA1c level, diabetes duration, hypertension, and chronic renal failure are globally recognized risk factors for the development of DR [3,4,5,6]

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