In Cheol Hwang1, Jeong Hun Bae2, Joon Mo Kim3. 1. Department of Family Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea. 2. Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. jhbae94@hotmail.com. 3. Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Abstract
PURPOSE: To evaluate the association of body mass index (BMI), waist circumference, and body fat with diabetic retinopathy (DR) in Korean patients with type 2 diabetes. METHODS: Among the 1130 participants 19 years of age or older with type 2 diabetes enrolled in the nationwide survey, a total of 887 participants were included in the analyses after excluding patients with ungradable fundus images. The presence and severity of DR were graded with seven-field fundus photographs. The associations between DR and anthropometric parameters and total body fat, which was assessed by dual-energy X-ray absorptiometry, were analysed using multivariate logistic regression models. RESULTS: Patients were divided into three groups according to severity of DR: no DR (n = 702, 79.1%), mild/moderate DR (n = 130, 14.7%), and vision-threatening DR (n = 55, 6.2%). In multivariate-adjusted analyses, higher BMI (adjusted odds ratio [aOR], 0.80; 95% confidence interval [CI], 0.70-0.92; P = 0.001), larger waist circumference (aOR, 0.96; 95% CI, 0.91-1.00; P = 0.047), and higher total body fat (aOR, 0.86; 95% CI, 0.79-0.92; P < 0.001) were significantly associated with a lower risk of vision-threatening DR. In sex-stratified analyses, however, only total body fat in women showed a significant inverse association with the presence of DR (aOR, 0.93; 95% CI, 0.88-0.98; P < 0.001) and independently with the severity of DR (P for trend = 0.004). CONCLUSION: In Korean patients with type 2 diabetes, obese patients might be less likely to have vision-threatening DR. Total body fat in women appears to be inversely and independently associated with DR prevalence and progression.
PURPOSE: To evaluate the association of body mass index (BMI), waist circumference, and body fat with diabetic retinopathy (DR) in Korean patients with type 2 diabetes. METHODS: Among the 1130 participants 19 years of age or older with type 2 diabetes enrolled in the nationwide survey, a total of 887 participants were included in the analyses after excluding patients with ungradable fundus images. The presence and severity of DR were graded with seven-field fundus photographs. The associations between DR and anthropometric parameters and total body fat, which was assessed by dual-energy X-ray absorptiometry, were analysed using multivariate logistic regression models. RESULTS:Patients were divided into three groups according to severity of DR: no DR (n = 702, 79.1%), mild/moderate DR (n = 130, 14.7%), and vision-threatening DR (n = 55, 6.2%). In multivariate-adjusted analyses, higher BMI (adjusted odds ratio [aOR], 0.80; 95% confidence interval [CI], 0.70-0.92; P = 0.001), larger waist circumference (aOR, 0.96; 95% CI, 0.91-1.00; P = 0.047), and higher total body fat (aOR, 0.86; 95% CI, 0.79-0.92; P < 0.001) were significantly associated with a lower risk of vision-threatening DR. In sex-stratified analyses, however, only total body fat in women showed a significant inverse association with the presence of DR (aOR, 0.93; 95% CI, 0.88-0.98; P < 0.001) and independently with the severity of DR (P for trend = 0.004). CONCLUSION: In Korean patients with type 2 diabetes, obesepatients might be less likely to have vision-threatening DR. Total body fat in women appears to be inversely and independently associated with DR prevalence and progression.
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