Risk Factors For Diabetic Retinopathy Research Articles

Non-mydriatic fundus camera screening with diagnosis by telemedicine for diabetic retinopathy patients with type 1 and type 2 diabetes: a hospital-based cross-sectional study.

ABSTRACTBACKGROUND: Diabetic retinopathy (DR) is considered the fifth leading cause of visual impairment worldwide and is associated with a huge social and economic burden.OBJECTIVE: Describe the practicality of non-mydriatic funduscopic screening photography for the detection of DR among patients with type 1 and type 2 diabetes.DESIGN: Cross-sectional hospital-based study.SETTING: Diabetes center, Riyadh.PATIENTS AND METHODS: Between July and December 2017, patients with diabetes and aged ≥18 years were selected by systematic random sampling from the University Diabetes Center. Fundoscopic eye examination was performed using the TRC-NW8 non-mydriatic camera, which performs ocular coherence tomography (OCT) to detect macular edema. Using telemedicine, pictures were graded by a retinal-specialized ophthalmologist using the international clinical DR disease severity scale. Patients were classified according to the type and severity of DR.MAIN OUTCOME MEASURES: Detection and classification of DR.SAMPLE SIZE: 978 Saudi patients with diabetes.RESULTS: Of 426 (43.5%) patients with DR, 370 had nonproliferative DR and 55 had proliferative DR. Nineteen (1.9%) had macular edema. The most important risk factors for DR were longer diabetes duration and poor glycemic control. Both older age and insulin use contributed to the higher prevalence of DR and macular edema. DR was more common among type 1 patients at 55.4% compared with 49% among type 2 patients. In addition, more females had macular edema (57.1% versus 42.9% among males). Nine patients with macular edema (47.3%) had hypertension while 154 of 426 patients with DR (36.2%) had hypertension.CONCLUSION: Non-mydriatic funduscopic screening photography was practical and useful for the detection of DR in patients with type 1 and type 2 diabetes.LIMITATIONS: Conducted in a single center.CONFLICT OF INTEREST: None.

Risk factors associated with diabetic retinopathy among patients with type 2 diabetes mellitus in central India

Risk factors associated with diabetic retinopathy among patients with type 2 diabetes mellitus in central India - IJCEO- Print ISSN No: - 2395-1443 Online ISSN No:- 2395-1451 Article DOI No:- 10.18231/j.ijceo.2019.080, Indian Journal of Clinical and Experimental Ophthalmology-Indian J Clin Exp Ophthalmol

Prevalence and risk factors for diabetic retinopathy in a cross-sectional population-based study from rural southern China: Dongguan Eye Study

Research questionThe current population-based study aimed to investigate the prevalence of diabetic retinopathy (DR) and risk factors among residents over 40 years old in the rural area of Dongguan, southern...

Association of diabetic retinopathy and diabetic macular oedema with renal function in southern Chinese patients with type 2 diabetes mellitus: a single-centre observational study

Background and objectivesThe association of diabetic retinopathy (DR) and diabetic macular oedema (DME) with renal function in southern Chinese patients with diabetes is poorly understood. So we aimed to study...

Serum CA 19-9 Level is Correlated to the Clinical Characteristics and Chronic Complications of Patients Newly Diagnosed with Type 2 Diabetes Mellitus.

This study investigated the relation of serum carbohydrate antigen 199 (CA 19-9) levels to the clinical characteristics and chronic complications of patients newly diagnosed with type 2 diabetes mellitus (T2DM). A total of 371 patients newly diagnosed with T2DM and 133 healthy people with consecutively matched age were compared. The 371 patients with T2DM were divided into four groups by quartiles based on their serum CA 19-9 levels, in which clinical characteristics and chronic complications, such as diabetic retinopathy (DR), diabetic nephropathy, and macrovascular complications were compared. Logistic regression analysis was used to evaluate the risk factors of DR. Among the 371 patients newly diagnosed with T2DM, 60 had elevated CA 19-9 levels (16.17%). The frequencies of elevated serum CA 19-9 were 24.39% (30 of 123) for females and 12.10% (30 of 248) for males, in which the values for females were higher than those for males (P<0.01).Differences were observed among the serum CA 19-9 levels, hemoglobin A1c (HbA1c), and DR (P<0.05). Logistic regression analysis showed that serum CA 19-9 levels, fasting blood glucose (FBG) and fasting C-peptide (FC-P) were risk factors for DR (P<0.05). Serum CA 19-9 levels were correlated with HbA1c and DR in patients newly diagnosed with T2DM. The elevated serum CA 19-9 levels, high FC-P, and FBG levels were important risk factors for DR in patients newly diagnosed with T2DM.

Serum Albumin, but not Bilirubin, is Associated with Diabetic Chronic Vascular Complications in a Chinese Type 2 Diabetic Population

To identify the factors associated with serum total bilirubin (STB) and determine whether STB is independently associated with diabetic retinopathy (DR) or diabetic kidney disease (DKD), 1,665 Chinese patients with type 2 diabetes (T2DM) (248 outpatients newly diagnosed with T2DM [NDM] and 1,417 inpatients previously diagnosed with T2DM [PDM]) were studied. Clinical and biochemical information was collected, and a single nucleotide polymorphism (rs6704078) of the UGT1A1 gene was genotyped in 1,059 individuals. Multiple linear regression showed that STB was associated with haemoglobin concentration, platelet count, and serum triglyceride concentration in NDM and PDM patients, and with serum albumin, duration of diabetes, and smoking in PDM patients. In patients with PDM, multiple logistic regression revealed that serum albumin was associated with DR (odds ratio [OR] = 0.92, 95% confidence interval [CI]: 0.87–0.96, p = 0.001) and DKD (OR = 0.93, 95% CI: 0.88–0.98, p = 0.005) after adjustment for STB, STB-related factors, and risk factors for DR and DKD. In addition, patients with the T allele of rs6704078 had higher STB (13.2 [10.4–17.9] μmol/L versus 11.8 (9.4–14.8) μmol/L; p < 0.001) and similar risks of DR or DKD to those without the T allele. Thus, serum albumin, but not STB, is associated with DR and DKD.

Распространенность и факторы риска диабетической ретинопатии в условиях разной доступности эндокринологической помощи

Распространенность и факторы риска диабетической ретинопатии в условиях разной доступности эндокринологической помощи

Risk factors for prevalent diabetic retinopathy and proliferative diabetic retinopathy in type 1 diabetes.

Age at diagnosis of type 1 diabetes (DM1) has been implied as an important factor associated with the development of the microvascular complications. Our aim was to identify factors associated with prevalent diabetic retinopathy (DR) and proliferative diabetic retinopathy (PDR) in DM1 people with early and late-onset. We reviewed medical records from all DM1 people from the reference area of a tertiary center (about 340,000 persons). Univariate and multivariate logistic regression were used to assess the relationship between potential risk factors (sociodemographic, diabetes-related, co-morbidities, and laboratory parameters) and prevalent DR/PDR. We performed an analysis comparing patients diagnosed before (early-onset) and after (late-onset) 18 years of age. We included 140 patients in early-onset DM1 group and 169 in late-onset DM1 group. Longer duration of diabetes and HbA1c remained associated with prevalent DR in both groups after adjusting for potential risk factors. Nephropathy was associated with prevalent DR in the late-onset group but not in the early-onset group. Peripheral neuropathy remained associated with prevalent PDR when modeled together in the multivariate model. High BMI demonstrated a significative association with PDR in early but not in the late-onset DM1 group. Although previous reports suggest that age at DM1 diagnosis may have a role in DR prevalence, the risk factors for DR in early and late-onset DM1 were similar for both groups. Duration of disease and lifelong metabolic control were the major predictors for DR in both groups. Nephropathy was associated with DR in patients with late-onset disease. Neuropathy was associated with PDR occurrence in both groups. BMI was associated with PDR early-onset DM1 group.

Frequency and risk factors of diabetic retinopathy in patients with type 2 diabetes presenting at a tertiary care hospital

To evaluate frequency and risk factors of diabetic retinopathy in patients with type 2 diabetes. This prospective observational study was conducted from January 2017 to June 2017 at the outpatient department of Baqai Institute of Diabetology and Endocrinology (BIDE) and Baqai Medical University a tertiary care diabetes hospital of Karachi, Pakistan. Convenience sampling was done. Demographic, anthropometric, clinical, and biochemical data were collected, and ophthalmic screening was performed by funduscopy at a slit lamp biomicroscopy with the help 90 D fundus lens. Grading of diabetic retinopathy was done according to the modified Early Treatment Diabetic Retinopathy Disease Severity Scale (ETDRS) criteria. Retinopathy was present in 17.5% of patients. Non-sight-threatening retinopathy was found in 15.2% and sight-threatening retinopathy was found in 17.6%. In table 4, logistic regression analysis determined the relationship between retinopathy and its possible risk factors. In univariate logistic regression model, Age, poor glycemic control and longer duration of diabetes were found to be significant risk factors for developing retinopathy. In multivariate logistic regression model, duration of diabetes remained significantly associated with the development of retinopathy. Additionally, gender was not significantly associated in univariate analysis but it became significant after adjustment in multivariate model. An early screening program reduces the risk of incidence of diabetic retinopathy. Hence, screening of retinopathy should be done once in a year.

1724-P: Interaction between Genetic Variants and Hemoglobin A1c Level on the Risk of Sight-Threatening Diabetic Retinopathy in Patients with Type 2 Diabetes

Objectives: While hemoglobin A1c (HbA1c) is a well-established risk factor of diabetic retinopathy (DR), it only accounts for limited variation in DR risk. Recent genome-wide association studies (GWAS) have identified some susceptibility single nucleotide polymorphisms (SNPs) for DR. This study aimed to evaluate the possible SNPxHbA1c interaction for the risk of sight-threatening DR (STDR) among patients with type 2 diabetes (T2DM). Methods: Sixty-nine SNPs that showed top association signals (P&amp;lt;5x10-4; r2&amp;lt;0.9) in previous GWAS of DR were genotyped in 1106 STDR cases and 2069 non-DR controls. The associations between the SNPs and STDR were examined by multiple logistic regression analyses with adjustment for the traditional risk factors. HbA1c level was dichotomized according to a cut-off of 7% as suggested for an optimal glycemic control of diabetes. Interaction with HbA1c was examined by implementing an interaction term of SNP x dichotomized HbA1c in the logistic regression model. Results: COL5A1 rs59126004 (P=0.016;OR=0.82), IGSF21-KLHDC7A rs3007729 (P=0.022;OR=0.86), LOC728275-LOC728316 rs227455 (P=0.031;OR=0.88), C6orf170 rs17083119 (P=0.035;OR=0.82) and SLC25A32 rs3098241 (P=0.046;OR=0.88) showed significant associations with STDR. Among these, COL5A1 rs59126004 also showed a significant interaction with HbA1c for the risk of STDR (Pinteraction=0.002). Stratified analysis showed that the minor allele of this SNP was associated with a reduced risk of STDR only in the patients with HbA1c &amp;lt;7% (P=1.79x10-4; OR=0.58), but not in patients with HbA1c ≥7%. Conclusions: We have demonstrated a potential interaction between the COL5A1 rs59126004 and HbA1c for the susceptibility to STDR. Further studies to validate our findings are warranted. Disclosure K. Ng: None. C. Lee: None. Y. Woo: None. H. Fong: None. R. Wong: None. K.S. Lam: None. C.Y. Cheung: None. Funding Hong Kong Health and Medical Research Fund; Hong Kong Special Administrative Region

Risk factors for diabetic retinopathy: About 454 patients

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Presence of diabetic retinopathy is lower in type 2 diabetic patients with non-alcoholic fatty liver disease.

To analyze the association between non-alcoholic fatty liver disease (NAFLD) and the presence of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM).Total 411 T2DM patients were divided into NAFLD and control groups. NAFLD was diagnosed by ultrasound. Retinopathy was diagnosed by fundus photography. All patients were screened based on medical history, physical examinations, and laboratory measurements.The prevalence of NAFLD and DR in T2DM patients was 60.8% and 40.9%, respectively. The presence of DR was associated with diabetes duration, systolic blood pressure (SBP), glycated hemoglobin (HbA1c), and proteinuria (all P < .001) using univariate and multivariate regression analyses. The prevalence of DR was lower in patients with NAFLD than those without NAFLD (37.2% vs 46.6%, P = .065), and significantly lower in patients with moderate and severe NAFLD (30.2% vs 46.6%, P = .012; 14.3% vs 46.6%, P = .024). The presence of DR in NAFLD patients was associated with diabetes duration (P = .032) in Chi-squared analysis.NAFLD and DR were highly prevalent in T2DM patients. Diabetes duration, SBP, HbA1c, and proteinuria were risk factors for DR in T2DM patients. The presence of DR was lower in T2DM patients with NAFLD, which was mainly due to their shorter diabetes duration.

Association of MnSOD-47C/TGENE Polymorphism (Rs 4880-47C/T) in Sudanese Patient with Diabetic Retinopathy

Background: Diabetic retinopathy (DR) is the common micro-vascular complication of diabetes mellitus (DM). It is the main cause of blindness among young adults worldwide. Poor glycemic control in addition to longer diabetic duration is the main risk factors for diabetic retinopathy. Many genes have been postulated as candidates for diabetic retinopathy. Little is known about anti-oxidative enzyme gene polymorphism and its association with diabetic retinopathy, mainly for catalase enzyme and manganese superoxide dismutase and glutathione genes. The study aims to assess the role of manganese superoxide dismutase MnSOD (rs4880) gene polymorphism in diabetic retinopathy Sudanese patients and its relation with MnSOD level. In addition to determine the association of Fasting Blood Glucose (FBS), HbA1c and Lipid in the pathogenesis of diabetic retinopathy.&#x0D; Methodology: The number of subject involved were 130 which, were classified into (n 60) clinically diagnosed as diabetic retinopathy and (n 70) diabetes mellitus without retinopathy as control group, age ranged from (22 – 80) years old, from Makkah Eye Complex. DNA was extracted and PCR product for MnSOD, gene segment was digested by NgoM enzymes, moreover gene polymorphisms were determined. Serum MnSOD, activity and FBS, TG, CHOL and HbA1c level were analyzed using Cobas Int 400 using absorption photometer and immunoassay methods respectively.&#x0D; Results: The results revealed that retinopathy is more common in female than male by approximately 2 fold =1.9:1. Type II is more common in our population that type 1. The majority of the patients had type II diabetes (128, 98.5%) and only 2(1.5%) patients were type I diabetes mellitus. The activity of MnSOD, was significantly higher in DNR when compared with DR (p= 0.003). Mean HbA1c and FBG concentration were significantly higher among DR than DNR p=0.001 and p=0.001 respectively. In contrast, mean serum CHOL and TG level revealed insignificant differences when compared DR with Diabetic without retinopathy (DNR).The genotyping for MnSOD-47C/T showed that the frequency of genotype CC was significantly lower in cases compared with control. Theses Associations for SNPs CCs, MnSOD-47C/T SNP rs4880, decreased risk after correction for multiple testing (OR = 0.088, 95% CI = 0.034-0.224 p= 0.001), While the frequency of the CT heterozygote genotype was significantly higher in cases group compare with control, the OR= 3.76(1.41-10.5), P=0.006. While frequency of the TT genotype was significantly higher in cases than controls. Theses Associations for MnSOD 47C/T SNP rs4880, increased risk after correction for multiple testing (OR = 5.31, 95% CI = 1.91-14.75, p= 0.001). The C allele is observed in 47% of the cases while the T allele – risky allele- observed in 73% of the cases, OR= 0.150(0.079-0.285), P=0.001 (Table 6).&#x0D; Conclusion: The study concludes that there is a significant association between MnSOD-47C/T (rs 4880) gene polymorphism and the occurrence of diabetic retinopathy in Sudanese population. There is a significant decrease in MnSOD levels and glycemic control in patients with the mutant allele T.

MON-156 Association of Adhesion Molecule with Diabetes, Diabetic Retinopathy, and Diabetic Kidney Disease

Diabetic retinopathy (DR) and Diabetic Kidney Diseases (DKD) are the common microvascular complication of diabetes and are responsible for the major cause of blindness and end-stage kidney disease worldwide. Variation in the level of cell adhesion molecules is an indicator of the pathogenesis of diabetes and its complications. We hypothesized that a significant difference in cell adhesion molecules (ICAM 1, VCAM 1, ESEL, PSEL and LSEL) in diabetic subjects which can help in prediction and progression of DR and DKD. To examine the association of cell adhesion molecules in diabetes, DR and DKD a cross-sectional study was conducted on a total of 467 type 2 diabetes (T2D) subjects with a duration of diabetes ≥10 years and age ≥ 35 years. The subjects were divided into four groups. The first group is T2D patients with DR (n=62); the second group is T2D patients with DKD (n=113) and the third group is T2D with both DR and DKD (n=154) and group four is T2D patients without DR and DKD as control (n=138). Serum cell adhesion molecules (ICAM 1, VCAM 1, ESEL, PSEL and LSEL) were assessed by biochip immunoassay. The mean age of participants was 54.64 ± 6.11 years. A total of 46.3% of T2D patients were having retinopathy and 57.7% were diagnosed with both DR and DKD. There was a significant difference between the cell adhesion molecules in DR and DKD groups. The cell adhesion molecules also showed significant correlation with common risk factors of DR and DKD. The higher level of cell adhesion molecules in DR and DKD is useful to identify the development and progression of diabetic complications. Thus, early identification can prevent the development of further complication through better management.

Deep learning in estimating prevalence and systemic risk factors for diabetic retinopathy: a multi-ethnic study

In any community, the key to understanding the burden of a specific condition is to conduct an epidemiological study. The deep learning system (DLS) recently showed promising diagnostic performance for diabetic retinopathy (DR). This study aims to use DLS as the grading tool, instead of human assessors, to determine the prevalence and the systemic cardiovascular risk factors for DR on fundus photographs, in patients with diabetes. This is a multi-ethnic (5 races), multi-site (8 datasets from Singapore, USA, Hong Kong, China and Australia), cross-sectional study involving 18,912 patients (n = 93,293 images). We compared these results and the time taken for DR assessment by DLS versus 17 human assessors – 10 retinal specialists/ophthalmologists and 7 professional graders). The estimation of DR prevalence between DLS and human assessors is comparable for any DR, referable DR and vision–threatening DR (VTDR) (Human assessors: 15.9, 6.5% and 4.1%; DLS: 16.1%, 6.4%, 3.7%). Both assessment methods identified similar risk factors (with comparable AUCs), including younger age, longer diabetes duration, increased HbA1c and systolic blood pressure, for any DR, referable DR and VTDR (p > 0.05). The total time taken for DLS to evaluate DR from 93,293 fundus photographs was ~1 month compared to 2 years for human assessors. In conclusion, the prevalence and systemic risk factors for DR in multi-ethnic population could be determined accurately using a DLS, in significantly less time than human assessors. This study highlights the potential use of AI for future epidemiology or clinical trials for DR grading in the global communities.

Related Risk Factors between Subclinical Carotid Atherosclerosis and Diabetic Retinopathy in Newly Diagnosed Type 2 Diabetes Mellitus in China.

To analyze the clinical features and related risk factors in diabetic retinopathy (DR) and subclinical atherosclerosis, the micro- and macro-vascular diseases in newly diagnosed type 2 diabetes mellitus (T2DM). A retrospective study of 435 cases of inpatients with newly diagnosed T2DM from 2013-2017, and compare the 2 types of T2DM related vascular complications. The macro- and microvascular complications are not rare at this stage. Subclinical atherosclerosis was found in 251 subjects (57.7%), which was higher than that of DR (13.1%). In addition, some cases of subclinical atherosclerosis co-existed with DR, suggesting that DR was related with subclinical atherosclerosis (r=0.098, P=0.041). Older age showed a significant association with both subclinical atherosclerosis and DR. Single factor analysis indicated that dyslipidemia was the common risk factor in DR and subclinical atherosclerosis. It should be paid attention to the screening of both DR and subclinical atherosclerosis in each age group of newly diagnosed T2DM. Except for the control of blood glucose, the control of the dyslipidemia is important in the prevention and treatment of the micro- and macro-vascular diseases.

The establishment and preliminary verification of a risk model for the prediction of diabetic retinopathy in patients with type 2 diabetes

Objective To establish an appropriate diabetic retinopathy (DR) risk assessment model for patients with type 2 diabetes mellitus (T2DM). Methods A retrospective clinical analysis. From January 2016 to December 2017, 753 T2DM patients in the Third Affiliated Hospital of Southern Medical University were analyzed retrospectively. Digital fundus photography was taken in all patients. Fasting plasma glucose (FPG), HbA1c, total bilirubin (TB), blood platelet, total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-c), low density lipoprotein cholesterol (LDL-c), apolipoprotein-A (apoA), apolipoprotein-B (apoB), serum creatinine, blood urea nitrogen (BUN), blood uric acid, fibrinogen (Fg), estimated glomerular filtration (eGFR) were collected. The patients were randomly assigned to model group and testify group, each had 702 patients and 51 patients respectively. Logistic regression was used to screen risk factors of DR and develop an assessment scale that can be used to predict DR. Goodness of fit was examined using the Hosmer- Lemeshow test and the area under the receiver operating characteristic (ROC) curve. Results Among 702 patients in the model group, 483 patients were DR, 219 patients were NDR. The scores for DR risk were duration of diabetes ≥4.5 years, 4 points; total bilirubin <6.65 mol/L, 2 points; apoA≥1.18 g/L, 2 points; blood urea≥ 6.46 mmol/L, 1 points; HbA1c ≥7.75%, 2 points; HDL-c <1.38 mmol/L, 2 points; diabetic nephropathy, 3 points; fibrinogen, 1 point. The area under the receiver operating characteristic curve was 0.787. The logistic regression analysis showed that the risk factors independently associated with DR were duration of diabetes (β=1.272, OR=3.569, 95%CI 2.283−5.578, P<0.001), TB (β=0.744, OR=2.104, 95%CI 1.404−3.152, P<0.001, BUN (β=0.401, OR=1.494, 95%CI 0.996−2.240, P=0.052), HbA1c (β=0.545, OR=1.724, 95%CI 1.165−2.55, P=0.006), HDL-c (β=0.666, OR=1.986, 95%CI 1.149−3.298, P=0.013), diabetic nephropathy (β=1.151, OR=3.162, 95%CI 2.080−4.806, P=0.013), Fg (β=0.333, OR=1.396, 95%CI 0.945−2.061, P=0.094). The risk model was P=1/[1+exp−(−3.799+1.272X1+0.744X2+0.769X3+0.401X4+0.545X5+0.666X6+1.151X7+0.333X8)]. X1= duration of diabetes, X2=TB, X3=apoA, X4=BUN, X5=HbA1c, X6=HDL-c, X7=diabetic nephropathy, X8=Fg. The area under the ROC curve was 0.787 and the Hosmer-Lemeshow test suggested excellent agreement (χ2=10.125, df=8, P=0.256) in model group. The area under the ROC curve was 0.869 and the Hosmer-Lemeshow test suggested excellent agreement (χ2=5.345, df=7, P=0.618) in model group. Conclusion The area under the ROC curve for DR was 0.787. The duration of diabetes, TB, BUN, HbA1c, HDL-c, diabetic nephropathy, apoA, Fg are the risk factors of DR in T2DM patients. Key words: Diabetic retinopathy/prevention & control; Models, statistical; Forecasting

High HDL cholesterol: A risk factor for diabetic retinopathy? Findings from NO BLIND study

AimsTo assess the correlation between diabetic retinopathy (DR) and potential risk factors, as well as the relationship between DR and the other complications of diabetes, in a real-life population of type 2 diabetes patients recruited in several centres in Italy. MethodsThe NO BLIND is a cross-sectional, multicentre, observational study, which involved nine public outpatient clinics in Italy. The patients were assessed for eligibility from November 2016 till November 2017. Those enrolled underwent standard fundus oculi exam. Clinical and laboratory data were also collected. Results2068 T2DM underwent fundus oculi exam. 435 received diagnosis of diabetic retinopathy (21%). Diabetic retinopathy was independently associated with HDL cholesterol (O.R.: 1.042; 95% C.I.: 1.012–1.109; p = 0.004), Albumin Excretion Rate (AER) (O.R.: 1.001; 95% C.I.: 1.000–1.002; p = 0.034) and GFR (O.R.: 1.159; 95% C.I.: 1.039–1.294; p = 0.008). HDL cholesterol values were hence split in two classes according to a potential cut-off (40 mg/dL), as defined by the ROC curve. Following analysis confirmed the association between DR and high HDL values (p = 0.032). Somatic neuropathy and diabetic ulcer were independently related with DR (p < 0.001 and p = 0.012, respectively). ConclusionsA novel relationship between high HDL cholesterol and DR was observed.

Effect of adiponectin level and genetic variation of its receptors on diabetic retinopathy: A case-control study.

Adiponectin (APN) and its receptors have been reported to be associated with metabolic phenotypes. To better understand the effects of APN levels and its receptors on diabetic retinopathy (DR), we investigated the association of the plasma APN level and variations in APN-related genes with DR, individually and in combination.Patients with type 2 diabetes (T2D; N = 1604), above 20 years of age from the Taiwanese population participated in the study. Demographic information, blood pressure, and serological markers were recorded at enrollment. Genomic DNA was isolated and genotyped. The plasma APN levels were measured by enzyme-linked immunosorbent assay.T2D patients with DR (N = 632) had diabetes for a longer duration, and had higher HbA1c, and systolic and diastolic blood pressure compared to those without DR (N = 972) (P < .001, for all the parameters). Overall, 10 single nucleotide polymorphisms (SNPs) in ADIPOQ and CDH13 susceptibility loci were associated with DR. Gene risk score (GRS) was calculated based on 10 SNPs for each subject and the cumulative effect of genes was observed. Among the subjects with plasma APN level (N = 518), natural logarithm (LN) of APN (LN [APN]; odds ratio [OR] = 1.63, 95% confidence interval [CI] = 1.19-2.25) and GRS (OR = 1.90, 95% CI = 1.11-3.26 for middle range of GRS, and OR = 2.61, 95% CI = 1.48-4.59 for high range of GRS) were independent risk factors for DR after adjustment for other parameters.In conclusion, the plasma APN level and the genetic variations in adiponectin receptors were associated with DR.

Six-year incidence and progression of diabetic retinopathy in Indian adults: the Singapore Indian Eye study

AimsDiabetes is a major public health problem in migrants and ethnic minorities worldwide. We determined the incidence and risk factors of diabetic retinopathy (DR) in migrant Indians living in Singapore.MethodsWe...