Risk factors associated with diabetic retinopathy onset and progression in diabetes patients: a Taiwanese cohort study.

Diabetic retinopathy (DR) is a common complication of type 2 diabetes mellitus (T2DM) and the leading cause of adult blindness. This study aimed to clarify the risk factors associated with DR onset and progression in patients with T2DM in Taiwan. This retrospective analysis enrolled 743 T2DM patients, including 170 with DR and 573 without DR at baseline who were enrolled in the Diabetes Shared-Care Program. The average follow-up period was 2.9 years. Variables, including demographic characteristics, DM duration, anthropometric data and clinical laboratory results, were compared between patients with DR at baseline, those with new-onset DR, and patients without DR using a chi-squared test and one-way ANOVA. A multivariate Cox proportional hazards model was performed to identify risk factors associated with progression of preexisting DR or new-onset DR. During the follow-up period, 38 (22.4%) patients with preexisting DR experienced disease progression, and 91 (15.9%) patients had new-onset DR. Multivariate analysis revealed that the presence of neuropathy (HR: 3.96, 95% CI: 1.84, 8.53) and diastolic blood pressure (HR: 1.05, 95% CI: 1.02, 1.08) were associated with increased risk of DR progression (both P < 0.001). Factors associated with new-onset DR included neuropathy, systolic BP, cholesterol, and updated mean of HbA1c (all P ≤ 0.001). The risk factors associated with DR onset and progression in Taiwanese patients with T2DM are different. Neuropathy and blood pressure increased the risk of both DR onset and progression; however, the risk of DR onset was also increased with updated mean of HbA1c and cholesterol.