Abstract
ObjectiveTo assess the cumulative 10-year incidence of diabetic retinopathy (DR) and its associated factors in a population living in Greater Beijing.MethodsThe population-based longitudinal Beijing Eye Study, which included 4439 subjects (age in 2001: 40+years) in 2001, was repeated in 2011 with 2695 subjects participating (66.4% of the survivors). The study participants underwent a detailed ophthalmic examination. Fundus photographs were examined for the new development of DR.ResultsAfter excluding individuals with DR at baseline (n = 87) or no sufficient fundus photographs in 2011 (n = 6), the study included 2602 subjects with a mean age of 64.6±9.7 years (median: 64.0 years; range: 50 to 93 years). In the 10-year period, 109 subjects (39 men) developed new DR with an incidence of 4.2% (95% confidence interval (CI): 3.45,5.03). In multiple logistic regression analysis, incident DR was significantly associated with higher HbA1c value (P<0.001; Odds Ratio (OR): 1.73; 95% Confidence Interval (CI): 1.35,2.21), longer duration of diabetes mellitus (P<0.001; OR: 1.16; 95% CI: 1.10,1.22), higher serum concentration of creatinine (P = 0.02; OR: 1.01; 95% CI: 1.002,1.022), lower educational level (P = 0.049; OR: 0.74; 95% CI: 0.55,0.99), higher estimated cerebrospinal fluid pressure (P = 0.038; OR: 1.10; 95% CI: 1.01,1.22), and shorter axial length (P<0.001; OR: 0.48; 95% CI: 0.33,0.71).ConclusionsThe cumulative 10-year incidence (mean: 4.2%) of DR in a North Chinese population was significantly associated with a higher HbA1c value, longer known duration of diabetes mellitus, higher estimated CSFP and shorter axial length (P<0.001). Shorter axial length (or hyperopia) and, potentially, higher CSFP may be additional risk factors to be taken into account when counseling and treating patients with diabetes mellitus.
Highlights
As one of the leading causes of visual impairment and blindness in the middle-aged population, diabetic retinopathy (DR) has been an increasing threat to quality of life for millions of people worldwide [1,2,3]
In multiple logistic regression analysis, incident DR was significantly associated with higher HbA1c value (P,0.001; Odds Ratio (OR): 1.73; 95% Confidence Interval (CI): 1.35,2.21), longer duration of diabetes mellitus (P,0.001; OR: 1.16; 95% CI: 1.10,1.22), higher serum concentration of creatinine (P = 0.02; OR: 1.01; 95% CI: 1.002,1.022), lower educational level (P = 0.049; OR: 0.74; 95% CI: 0.55,0.99), higher estimated cerebrospinal fluid pressure (P = 0.038; OR: 1.10; 95% CI: 1.01,1.22), and shorter axial length (P,0.001; OR: 0.48; 95% CI: 0.33,0.71)
The cumulative 10-year incidence of DR in a North Chinese population was significantly associated with a higher HbA1c value, longer known duration of diabetes mellitus, higher estimated Cerebrospinal fluid pressure (CSFP) and shorter axial length (P,0.001)
Summary
As one of the leading causes of visual impairment and blindness in the middle-aged population, diabetic retinopathy (DR) has been an increasing threat to quality of life for millions of people worldwide [1,2,3]. Apart from visual morbidity, evidence has been accumulated that the presence of DR indicates an increased risk of systemic vascular diabetic complications including stroke, coronary heart disease and heart failure, and nephropathy [4]. Most of these studies addressing the frequency of DR and its associated factors were designed as cross-sectional investigations, while only few longitudinal studies exist [5,6,7,8,9,10,11,12,13,14,15,16,17]. We conducted our study to examine the cumulative incidence of DR in a population living in an urban region and in a developed rural region of Greater Beijing, and simultaneously to explore factors associated with the new development of DR in the study population
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