Associations between diabetic retinopathy and systemic risk factors

Abstract

Introduction: Diabetes mellitus is a systemic disease with complications that include sight-threatening diabetic retinopathy. It is essential to understand the risk factors of diabetic retinopathy before effective prevention can be implemented. The aim of this review was to examine the association between diabetic retinopathy and systemic risk factors.Methods: A PubMed literature search was performed up to May 2016 to identify articles reporting associations between diabetic retinopathy and systemic risk factors; only publications written in English were included. Relevant articles were selected and analysed. Results:Patients with diabetic retinopathy were more likely to have poor glycaemic control as reflected by a higher glycated haemoglobin, longer duration of diabetes, and use of insulin therapy for treatment. For other systemic risk factors, hypertension was positively associated with prevalence and progression of diabetic retinopathy. No clear association between obesity, hyperlipidaemia, gender, or smoking with diabetic retinopathy has been established as Associations between diabetic retinopathy and systemic risk factors IntroductionDiabetic retinopathy is the leading cause of blindness in adults living in developed countries. 1 Almost all patients with type 1 diabetes mellitus (DM) and more than 60% of patients with type 2 DM will develop some degree of retinopathy after a 20-year history of diabetes.2 It has also been well established that DM increases the risk of cardiovascular disease. 3Cheng et al 4 found that the prevalence of diabetic retinopathy associated with one, two, three, or four cardiometabolic risk factors was 16.0%, 17.6%, 21.3%, or 25.1%, respectively (P=0.001). This implies a relationship between systemic health conditions and diabetic retinopathy. In order to help identify and to prevent progression of this ophthalmic complication of diabetes, a better understanding of its association with systemic risk factors is necessary. MethodsA PubMed literature search was conducted up to May 2016 using the following key words: "diabetic retinopathy", "prevalence", "epidemiology", "systemic associations", "risk factors", "diabetic Hong Kong Med J 2016;22:589-99

Psychometric assessment and application of the Chinese version of the Compliance with Annual Diabetic Eye Exams Survey in people with diabetic retinopathy

“…As demonstrated in previous studies, however, multiple factors (e.g. older age, longer duration of diabetes, complicated with other chronic diseases) play a role in the development and progression of diabetic retinopathy [10,17,20], hence it is necessary to remind people with diabetes that good blood glucose control alone may not entirely prevent the development of diabetic retinopathy [21].…”

The Role of Glycemic Control and Variability in Diabetic Retinopathy

“…DR currently affects almost 100 million people worldwide and is becoming an ever-increasing health burden, with estimates between 1990 and 2010 showing that DR-related visual impairment and blindness increased by 64% and 27%, respectively [2]. Several risk factors have been associated with DR, while good glycemic and blood pressure control are considered the most important modifiable risk factors to reduce the risk of progression of DR and vision loss [3]. However, recent studies have shown that the improvement in visual acuity and DR severity score after intravitreal anti-vascular endothelial growth factor (anti-VEGF) agents seem to be independent of baseline HbA1c [4].…”

Meta-Analysis on the Association of ALDH2 Polymorphisms and Type 2 Diabetic Mellitus, Diabetic Retinopathy

“…During the pathogenesis of T2DM, many risk factors and genetic variants are involved, such as drinking, hyperlipidemia, etc. [3]. Among these factors, the associations between alcohol drinking and T2DM have been widely studied [4,5].…”