Association of obesity with diabetic retinopathy in US adults with diabetes in a national survey

Abstract

Objective: There is a lack of consensus on whether a high body mass index (BMI) increases the risk of diabetic retinopathy (DR). We aimed to investigate the association between BMI, overweight, obesity, and DR using the data of diabetes respondents in the 2015 US Behavioral Risk Factor Surveillance System survey. Methods: Diabetes respondents aged over 18-year-old with complete information as well as undergone fundus examination in the past two years or had been diagnosed with DR were included. Weighted logistic regression analyses were used to identify the association of BMI with DR. Results: Among the 21,647 diabetes respondents, 4588 respondents had DR with a weighted prevalence of 22.5%. The mean BMI of all diabetes respondents was 31.50±6.95 kg/m2 with18,498 (86.5%) overweight and 11,353 (54.6%) obese. The mean BMI of the DR group (31.83±7.41kg/m2) was significantly higher than that of the non-DR group (31.41±6.81kg/m2, p<0.05). The proportion of obese respondents in the DR group was higher than the non-DR group (54.3%, p<0.001).The weighted prevalence of DR was 0.8%, 13.8%, 29.7%, and 55.7% for the emaciation group, the normal weight group, the overweight group, and the obesity group, respectively (p<0.001). Weighted logistic regression analysis showed that both BMI (adjusted OR=1.004, 95%CI 1.003-1.004) and obesity (adjusted OR=1.051, 95%CI 1.048-1.055) were associated with DR after adjusting for the confounding variables. However, overweight was not significantly associated with DR. Conclusion: The prevalence of DR in the normal weight, overweight, and obesity groups increased gradually. Obesity, rather than overweight, was significantly associated with increased DR prevalence.

Patterns of risk for diabetic retinopathy in the Mumbai slums: The Aditya Jyot Diabetic Retinopathy in Urban Mumbai Slums Study (AJ-DRUMSS) Report 3

“…In several studies from multiple countries, there was no association between DR and measures of obesity [18,40,47,48]. Other studies have shown that increasing BMI or obesity measured using various metrics increased odds, especially among those who are obese, and, in some cases, obesity associated with more severe DR (PDR vs NPDR) [49][50][51][52][53]. However, in studies that had results showing positive association between obesity and DR the average BMI was usually higher than in our study population with sample means over 30 as compared to mean values ~26 in our Mumbai slum sample.…”

Unusual patterns of risk for diabetic retinopathy in the Mumbai slums: The Aditya Jyot Diabetic Retinopathy in Urban Mumbai Slums Study (AJ-DRUMSS) Report 3

“…In several studies from multiple countries, there was no association between DR and measures of obesity (18,41,48,49). Other studies have shown that increasing BMI or obesity measured using various metrics increased risk, especially among those who are obese, and, in some cases, obesity associated with more severe DR (PDR vs NPDR) (50)(51)(52)(53)(54). However, in studies that had results showing positive association between obesity and DR the average BMI was usually higher than in our study population with sample means over 30 as compared to mean values ~26 in our Mumbai slum sample.…”

Prevalence of Diabetic Retinopathy and Associated Risk Factors in the Southern Region of Bangladesh

“…One such study, which concentrated on screening practices in Iran, discovered that the frequency of DR rose with age from 55 to 74 years 30 . According to research conducted in southern India, people aged 60 to 69 are the most frequent group to suffer from DR 34 .…”