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Erschienen in: Journal of Diabetes & Metabolic Disorders 1/2018

28.04.2018 | Research Article

Is there a relationship between body mass index and diabetic retinopathy in type II diabetic patients? A cross sectional study

verfasst von: Zahra Sarrafan-chaharsoughi, Masoud Reza Manaviat, Nasim Namiranian, Pouria Yazdian-Anari, Masoud Rahmanian

Erschienen in: Journal of Diabetes & Metabolic Disorders | Ausgabe 1/2018

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Abstract

Background

Type 2 diabetes mellitus (T2DM) is one of the most important leading causes of disability, premature mortality and Diabetic Retinopathy (DR) that is one of the diabetes-related complications in diabetic patients and the most common cause of vision loss in diabetic patients. The aim of the study was to evaluate the association between DR and body mass index (BMI) in those patients with T2DM.

Methods

This was a central-based, cross-sectional study on 518 diabetic patients. Their medical history and the laboratory data were collected. All the patients received examination of diabetic retinopathy by professional ophthalmologist. Based on their optic fundi findings, they were classified into five groups: No retinopathy, Mild Non-proliferative Diabetic Retinopathy (NPDR), Moderate NPDR, Severe NPDR, Proliferative diabetic retinopathy (PDR). To analysis data SPSS v18 software used. Frequency, percent, mean and standard deviation were used for population description. t test, spearman correlation, partial correlation, analysis of variance (ANOVA) and Chi-square test (χ2) were used for analytic analysis. Multivariate logistic regression was used to estimate the odds ratio.

Results

518 patients with T2DM 198 male (38%), 320 female (62%) included in this study. The mean age of patients was 61.02 ± 10.18 years. The mean age at onset was 49.06 + 10.52 years and the mean duration of diabetes was 12.09 ± 7.81 years. There was a strong relationship between duration of diabetes and DR (P = 0.001). There were strong significant association between the development of DR and Insulin therapy (OR = 5.975). Correlation analysis between Retinopathy and BMI showed that BMI had inverse relationship with DR when BMI considered as a continuous variable (p-value = 0.009 and correlation coefficient = −0.467).

Conclusion

BMI in diabetic patient is one of the most important clinical parameter for their health and disease progression. We conclude that BMI had inverse relationship with DR when BMI considered as a continuous variable.
Literatur
1.
Zurück zum Zitat Roglic G, et al. The burden of mortality attributable to diabetes: realistic estimates for the year 2000. Diabetes Care. 2005;28:2130–5.CrossRefPubMed Roglic G, et al. The burden of mortality attributable to diabetes: realistic estimates for the year 2000. Diabetes Care. 2005;28:2130–5.CrossRefPubMed
2.
Zurück zum Zitat Beaglehole R, Epping-Jordan J. Preventing chronic diseases, a vital investment. Geneva: World Health Organization; 2005. Beaglehole R, Epping-Jordan J. Preventing chronic diseases, a vital investment. Geneva: World Health Organization; 2005.
3.
Zurück zum Zitat World Health Organization. Prevention of diabetes mellitus. Report of a WHO study group. Geneva: World Health Organization No 844; 1994. World Health Organization. Prevention of diabetes mellitus. Report of a WHO study group. Geneva: World Health Organization No 844; 1994.
4.
Zurück zum Zitat Tseng CH, Tseng CP, Chong CK, et al. Increasing incidence of diagnosed type 2 diabetes in Taiwan: analysis of data from a national cohort. Diabetologia. 2006;49(8):1755–60.CrossRefPubMed Tseng CH, Tseng CP, Chong CK, et al. Increasing incidence of diagnosed type 2 diabetes in Taiwan: analysis of data from a national cohort. Diabetologia. 2006;49(8):1755–60.CrossRefPubMed
5.
Zurück zum Zitat Guariguata L, Whiting D, Weil C, Unwin N. The international diabetes federation diabetes atlas methodology for estimating global and national prevalence of diabetes in adults. Diabetes Res Clin Pract. 2011 Dec 31;94(3):322–32.CrossRefPubMed Guariguata L, Whiting D, Weil C, Unwin N. The international diabetes federation diabetes atlas methodology for estimating global and national prevalence of diabetes in adults. Diabetes Res Clin Pract. 2011 Dec 31;94(3):322–32.CrossRefPubMed
6.
Zurück zum Zitat US Centers for Disease Control and Prevention. National Diabetes Fact Sheet: general information and National Estimates on diabetes in the United States. Atlanta, GA: centers for disease control and Prevention; 2005. US Centers for Disease Control and Prevention. National Diabetes Fact Sheet: general information and National Estimates on diabetes in the United States. Atlanta, GA: centers for disease control and Prevention; 2005.
7.
Zurück zum Zitat Klein R, et al. The Wisconsin epidemiological study of diabetic retinopathy: II. Prevalence and risk of diabetic retinopathy when age at diagnosis is less than 30 years. Arch Ophthalmol. 1984;102(4):520–6.CrossRefPubMed Klein R, et al. The Wisconsin epidemiological study of diabetic retinopathy: II. Prevalence and risk of diabetic retinopathy when age at diagnosis is less than 30 years. Arch Ophthalmol. 1984;102(4):520–6.CrossRefPubMed
8.
Zurück zum Zitat Heydari B, Yaghoubi G, Yaghoubi MA, Miri MR. Prevalence and risk factors for diabetic retinopathy: an Iranian eye study. Eur J Ophthalmol. 2012;22:393–7.CrossRefPubMed Heydari B, Yaghoubi G, Yaghoubi MA, Miri MR. Prevalence and risk factors for diabetic retinopathy: an Iranian eye study. Eur J Ophthalmol. 2012;22:393–7.CrossRefPubMed
9.
Zurück zum Zitat UK Prospective Diabetes Study (UKPDS) Group, author. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998;352:837–53.CrossRef UK Prospective Diabetes Study (UKPDS) Group, author. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998;352:837–53.CrossRef
10.
Zurück zum Zitat Stratton IM, Kohner EM, Aldington SJ, Turner RC, Holman RR, Manley SE, et al. UKPDS 50: risk factors for incidence and progression of retinopathy in type II diabetes over 6 years from diagnosis. Diabetologia. 2001;44:156–63.CrossRefPubMed Stratton IM, Kohner EM, Aldington SJ, Turner RC, Holman RR, Manley SE, et al. UKPDS 50: risk factors for incidence and progression of retinopathy in type II diabetes over 6 years from diagnosis. Diabetologia. 2001;44:156–63.CrossRefPubMed
11.
Zurück zum Zitat UK Prospective Diabetes Study Group. Author. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. BMJ. 1998;317:703–13.CrossRefPubMedCentral UK Prospective Diabetes Study Group. Author. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. BMJ. 1998;317:703–13.CrossRefPubMedCentral
12.
Zurück zum Zitat Tyrberg M, Nyström L, Arnqvist HJ, Bolinder J, Gudbjörnsdottir S, Landin-Olsson M, et al. Hyperglycemia and tobacco use are modifiable risk factors for onset of retinopathy 9 and 17 years after the diagnosis of diabetes-a retrospective observational nation-wide cohort study. Diabetes Res Clin Pract. 2017 Aug 24;133:21–9.CrossRefPubMed Tyrberg M, Nyström L, Arnqvist HJ, Bolinder J, Gudbjörnsdottir S, Landin-Olsson M, et al. Hyperglycemia and tobacco use are modifiable risk factors for onset of retinopathy 9 and 17 years after the diagnosis of diabetes-a retrospective observational nation-wide cohort study. Diabetes Res Clin Pract. 2017 Aug 24;133:21–9.CrossRefPubMed
13.
Zurück zum Zitat Younis N, Broadbent D, Vora J, Harding S. Incidence of sight-threatening retinopathy in patients with type 2 diabetes in the Liverpool diabetic eye study: a cohort study. Lancet. 2003;361:195–200.CrossRefPubMed Younis N, Broadbent D, Vora J, Harding S. Incidence of sight-threatening retinopathy in patients with type 2 diabetes in the Liverpool diabetic eye study: a cohort study. Lancet. 2003;361:195–200.CrossRefPubMed
14.
Zurück zum Zitat Klein R, Klein BEK, Moss SE, Davis MD, DeMets DL. The Wisconsin epidemiologic study of diabetic retinopathy. III. Prevalence and risk of diabetic retinopathy when age at diagnosis is 30 or more years. Arch Ophthalmol. 1984;102:527–32.CrossRefPubMed Klein R, Klein BEK, Moss SE, Davis MD, DeMets DL. The Wisconsin epidemiologic study of diabetic retinopathy. III. Prevalence and risk of diabetic retinopathy when age at diagnosis is 30 or more years. Arch Ophthalmol. 1984;102:527–32.CrossRefPubMed
15.
16.
Zurück zum Zitat Matthews DR, Stratton IM, Aldington SJ, Holman RR, Kohner EM. Risks of progression of retinopathy and vision loss related to tight blood pressure control in type 2 diabetes mellitus: UKPDS 69. Arch Ophthalmol. 2004;122(11):1631–40.CrossRefPubMed Matthews DR, Stratton IM, Aldington SJ, Holman RR, Kohner EM. Risks of progression of retinopathy and vision loss related to tight blood pressure control in type 2 diabetes mellitus: UKPDS 69. Arch Ophthalmol. 2004;122(11):1631–40.CrossRefPubMed
17.
Zurück zum Zitat Schrier RW, Estacio RO, Mehler PS, Hiatt WR. Appropriate blood pressure control in hypertensive and normotensive type 2 diabetes mellitus: a summary of the ABCD trial. Nat Clin Pract Nephrol. 2007;3(8):428–38.CrossRefPubMed Schrier RW, Estacio RO, Mehler PS, Hiatt WR. Appropriate blood pressure control in hypertensive and normotensive type 2 diabetes mellitus: a summary of the ABCD trial. Nat Clin Pract Nephrol. 2007;3(8):428–38.CrossRefPubMed
18.
Zurück zum Zitat Dowse GK, Humphrey AR, Collins VR, et al. Prevalence and risk factors for diabetic retinopathy in the multiethnic population of Mauritius. Am J Epidemiol. 1998;147:448–57.CrossRefPubMed Dowse GK, Humphrey AR, Collins VR, et al. Prevalence and risk factors for diabetic retinopathy in the multiethnic population of Mauritius. Am J Epidemiol. 1998;147:448–57.CrossRefPubMed
20.
Zurück zum Zitat Chaturvedi N, Fuller JH. Mortality risk by body weight and weight change in people with NIDDM. The WHO multinational study of vascular disease in diabetes. Diabetes Care. 1995;18:766–74.CrossRefPubMed Chaturvedi N, Fuller JH. Mortality risk by body weight and weight change in people with NIDDM. The WHO multinational study of vascular disease in diabetes. Diabetes Care. 1995;18:766–74.CrossRefPubMed
21.
Zurück zum Zitat Lee ET, Lee VS, Lu M, Russell D. Development of proliferative retinopathy in NIDDM: a follow-up study of American Indians in Oklahoma. Diabetes. 1992;41:359–67.CrossRefPubMed Lee ET, Lee VS, Lu M, Russell D. Development of proliferative retinopathy in NIDDM: a follow-up study of American Indians in Oklahoma. Diabetes. 1992;41:359–67.CrossRefPubMed
22.
Zurück zum Zitat West KM, Erdreich LJ, Stober JA. A detailed study of risk factors for retinopathy and nephropathy in diabetes. Diabetes. 1980;29:501–8.CrossRefPubMed West KM, Erdreich LJ, Stober JA. A detailed study of risk factors for retinopathy and nephropathy in diabetes. Diabetes. 1980;29:501–8.CrossRefPubMed
23.
Zurück zum Zitat Nilsson SV, Nilsson JE, Frostberg N, Emilsson T. The Kristianstad survey. II. Studies in a representative adult diabetic population with special reference to comparison with an adequate control group. Acta Med Scand Suppl. 1967;469:1–42.PubMed Nilsson SV, Nilsson JE, Frostberg N, Emilsson T. The Kristianstad survey. II. Studies in a representative adult diabetic population with special reference to comparison with an adequate control group. Acta Med Scand Suppl. 1967;469:1–42.PubMed
24.
Zurück zum Zitat Kornerup T. Studies in diabetic retinopathy: an investigation of 1,000 cases of diabetes. Acta Med Scand. 1955;153:81–101.CrossRefPubMed Kornerup T. Studies in diabetic retinopathy: an investigation of 1,000 cases of diabetes. Acta Med Scand. 1955;153:81–101.CrossRefPubMed
25.
Zurück zum Zitat Klein R, Klein BE, Moss SEI. Obesity related to microvascular and macrovascular complications in diabetes? The Wisconsin epidemiologic study of diabetic retinopathy. Arch Intern Med. 1997;157:650–6.CrossRefPubMed Klein R, Klein BE, Moss SEI. Obesity related to microvascular and macrovascular complications in diabetes? The Wisconsin epidemiologic study of diabetic retinopathy. Arch Intern Med. 1997;157:650–6.CrossRefPubMed
26.
Zurück zum Zitat Kaštelan S, Tomić M, Gverović Antunica A, Ljubić S, Salopek Rabatić J, Karabatić M. Body mass index: a risk factor for retinopathy in type 2 diabetic patients. Mediat Inflamm 2013 Nov 20;2013. Kaštelan S, Tomić M, Gverović Antunica A, Ljubić S, Salopek Rabatić J, Karabatić M. Body mass index: a risk factor for retinopathy in type 2 diabetic patients. Mediat Inflamm 2013 Nov 20;2013.
27.
Zurück zum Zitat Narendra V, John RK, Raghuram A, Ravindran RD, Nirmalan PK, Thulasiraj RD. Diabetic retinopathy among selfreported diabetics in southern India: a population-based assessment. Br J Ophthalmol. 2002;86:1014–8.CrossRef Narendra V, John RK, Raghuram A, Ravindran RD, Nirmalan PK, Thulasiraj RD. Diabetic retinopathy among selfreported diabetics in southern India: a population-based assessment. Br J Ophthalmol. 2002;86:1014–8.CrossRef
28.
Zurück zum Zitat National Institute of Diabetes and Digestion and Kidney Diseases. Clinical Guidelines on the Identification, Evaluation, and Treatment of overweight and obesity in adults: The Evidence Report. Bethesda (MD): National Heart, Lung, and Blood Institute; 1998 Sep. Report No.: 98–4083 Am J Clin Nutr 68(4):899–917. National Institute of Diabetes and Digestion and Kidney Diseases. Clinical Guidelines on the Identification, Evaluation, and Treatment of overweight and obesity in adults: The Evidence Report. Bethesda (MD): National Heart, Lung, and Blood Institute; 1998 Sep. Report No.: 98–4083 Am J Clin Nutr 68(4):899–917.
29.
Zurück zum Zitat Wilkinson CP, Ferris FL, Klein RE, Lee PP, Agardh CD, Davis M, et al. Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales. Ophthalmology. 2003 Sep 30;110(9):1677–82.CrossRefPubMed Wilkinson CP, Ferris FL, Klein RE, Lee PP, Agardh CD, Davis M, et al. Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales. Ophthalmology. 2003 Sep 30;110(9):1677–82.CrossRefPubMed
30.
Zurück zum Zitat World Health Organization. Global strategy for noncommunacable disease prevention and control. Geneva. Switzerland: World Health Organization; 1997. World Health Organization. Global strategy for noncommunacable disease prevention and control. Geneva. Switzerland: World Health Organization; 1997.
31.
Zurück zum Zitat Rahmanian M. Et al. dual burden of body weight among Iranian children and adolescents in 2003 and 2010: the CASPIAN-III study. Arch Med Sci. 2014;10(1):96–103.CrossRefPubMedPubMedCentral Rahmanian M. Et al. dual burden of body weight among Iranian children and adolescents in 2003 and 2010: the CASPIAN-III study. Arch Med Sci. 2014;10(1):96–103.CrossRefPubMedPubMedCentral
32.
Zurück zum Zitat Keen H, Lee ET, Russell D, Miki E, Bennett PH, Lu M. The appearance of retinopathy and progression to proliferative retinopathy: the WHO multinational study of vascular disease in diabetes. Diabetologia. 2001;44(2):S22–30.CrossRefPubMed Keen H, Lee ET, Russell D, Miki E, Bennett PH, Lu M. The appearance of retinopathy and progression to proliferative retinopathy: the WHO multinational study of vascular disease in diabetes. Diabetologia. 2001;44(2):S22–30.CrossRefPubMed
33.
Zurück zum Zitat van Leiden HA, et al. Blood pressure, lipids, and obesity are associated with retinopathy: the Hoorn study. Diabetes Care. 2002;25:1320–5.CrossRefPubMed van Leiden HA, et al. Blood pressure, lipids, and obesity are associated with retinopathy: the Hoorn study. Diabetes Care. 2002;25:1320–5.CrossRefPubMed
34.
Zurück zum Zitat Tolonen N, et al. Associations and interactions between lipid profiles, retinopathy and nephropathy in patients with type 1 diabetes: the Finn Diane study. J Intern Med. 2013;274:469–79.CrossRefPubMed Tolonen N, et al. Associations and interactions between lipid profiles, retinopathy and nephropathy in patients with type 1 diabetes: the Finn Diane study. J Intern Med. 2013;274:469–79.CrossRefPubMed
35.
Zurück zum Zitat Rooney D, et al. Body mass index and retinopathy in Asian populations with diabetes mellitus. Acta Diabetol. 2014;52(1):73–80.CrossRefPubMed Rooney D, et al. Body mass index and retinopathy in Asian populations with diabetes mellitus. Acta Diabetol. 2014;52(1):73–80.CrossRefPubMed
36.
Zurück zum Zitat Raman R, Rani PK, Gnanamoorthy P, Sudhir RR, Kumaramanikavel G, Sharma T. Association of obesity with diabetic retinopathy: Sankara Nethralaya diabetic retinopathy epidemiology and molecular genetics study (SN-DREAMS report no. 8). Acta Diabetol. 2010;47:209–15.CrossRefPubMed Raman R, Rani PK, Gnanamoorthy P, Sudhir RR, Kumaramanikavel G, Sharma T. Association of obesity with diabetic retinopathy: Sankara Nethralaya diabetic retinopathy epidemiology and molecular genetics study (SN-DREAMS report no. 8). Acta Diabetol. 2010;47:209–15.CrossRefPubMed
37.
Zurück zum Zitat Lu J, Hou X, Zhang L, Jiang F, Hu C, Bao Y, et al. Association between body mass index and diabetic retinopathy in Chinese patients with type 2 diabetes. Acta Diabetol. 2015:1–8. Lu J, Hou X, Zhang L, Jiang F, Hu C, Bao Y, et al. Association between body mass index and diabetic retinopathy in Chinese patients with type 2 diabetes. Acta Diabetol. 2015:1–8.
38.
Zurück zum Zitat Logue J, Walker JJ, Leese G et al (2013) Association between BMI measured within a year after diagnosis of type 2 diabetes and mortality. Diabetes Care. 2013;36:887–93. Logue J, Walker JJ, Leese G et al (2013) Association between BMI measured within a year after diagnosis of type 2 diabetes and mortality. Diabetes Care. 2013;36:887–93.
39.
Zurück zum Zitat He BB, Wei L, Gu YJ et al. Factors associated with diabetic retinopathy in Chinese patients with type 2 diabetes mellitus. Int J Endocrinol 2012. He BB, Wei L, Gu YJ et al. Factors associated with diabetic retinopathy in Chinese patients with type 2 diabetes mellitus. Int J Endocrinol 2012.
40.
Zurück zum Zitat Manaviat MR, Afkhami M. Shoja MR retinopathy and microalbuminuria in type II diabetic patients. BMC Ophthalmol. 2004;1:4–9. Manaviat MR, Afkhami M. Shoja MR retinopathy and microalbuminuria in type II diabetic patients. BMC Ophthalmol. 2004;1:4–9.
Metadaten
Titel
Is there a relationship between body mass index and diabetic retinopathy in type II diabetic patients? A cross sectional study
verfasst von
Zahra Sarrafan-chaharsoughi
Masoud Reza Manaviat
Nasim Namiranian
Pouria Yazdian-Anari
Masoud Rahmanian
Publikationsdatum
28.04.2018
Verlag
Springer International Publishing
Erschienen in
Journal of Diabetes & Metabolic Disorders / Ausgabe 1/2018
Elektronische ISSN: 2251-6581
DOI
https://doi.org/10.1007/s40200-018-0339-5

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