Diabetic retinopathy in newly diagnosed middle-aged and elderly diabetic patients. Prevalence and interrelationship with microalbuminuria and triglycerides

Abstract

Background: The exact role of factors such as serum lipids, body mass index and (micro-)albuminuria as possible determinants of diabetic retinopathy remains to be determined. We have scrutinized the prevalence of diabetic retinopathy and its concomitants in terms of risk factors and other diabetic complications in newly diagnosed diabetic patients. Methods: A population-based sample of 1,251 newly diagnosed diabetic patients aged 40 years or over was established in general practice. Median age was 65.3 years. Funduscopy was performed by practising ophthalmologists. Blood and urine analyses were centralised. Results: The overall prevalence of diabetic retinopathy was 5.0%. Only three patients had proliferative diabetic retinopathy. As expected, diabetic retinopathy and renal involvement, as expressed by the urinary albumin/creatinine ratio, were strongly positively associated. An intriguing finding was that of an inverse relationship between fasting triglycerides and diabetic retinopathy, an association that proved to be confined to microalbuminuric patients. An inverse association between body mass index and diabetic retinopathy was found only univariately. Conclusion: The low prevalence of diabetic retinopathy cannot be explained by the screening method alone, but rather by early detection of diabetes in a non-selective patient sample. It seems that renal involvement modifies the expected relationship between diabetic retinopathy and triglycerides, but a pathophysiological mechanism is not available.

Albuminuria and Diabetic Retinopathy in Type 2 Diabetes Mellitus Sankara Nethralaya Diabetic Retinopathy Epidemiology And Molecular Genetic Study (SN-DREAMS, report 12)

“…Though a very subtle connection has been reported between urinary albumin, DR and lipids [38], we did not find a significant association between serum lipids and albuminuria in our study. BMI was inversely related to macroalbuminuria, however, this finding may only reflect the worst nutritional state of patients with more advanced renal disease and not a causal relationship.…”

Chronic complications in newly diagnosed patients with Type 2 diabetes mellitus in India

“…the results for diabetic retinopathy are in contrast to findings of other studies showing higher prevalence in Romania (14.37%) and Taiwan (25.5%). [11121314] the prevalence of diabetic retinopathy in newly diagnosed patients among various studies, Chennai Urban Rural Epidemiology Study (CURES) (5.1%) and United Kingdom Prospective Diabetes Study (UKPDS) (35%) is shown below in Figure 2. [1516]…”

Increased Uric Acid and Glucose Concentrations in Vitreous and Serum of Patients with Diabetic Macular Oedema

“…The manifestation and the progression of DR are modified by multiple systemic factors such as arterial hypertension [1,6,8,10,11] , dyslipidaemia [4,6,8,12] , microalbuminuria [13] , insulin treatment [11] and ocular perfusion pressure [5] . However, their exact contribution to DR pathogenesis is in most cases unknown.…”