Retinopathy in Persons without Diabetes: The Los Angeles Latino Eye Study

Chao, Jennifer R.; Lai, Michelle; Azen, Stanley P.; Klein, Ronald; Varma, Rohit

doi:10.1167/iovs.07-0206

Cited by 32 publications

(29 citation statements)

References 30 publications

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“…In addition, small sample sizes and different grading criteria of DR in these three studies might be taken into consideration. Earlier studies have shown that age, 13,14 gender, 14,15 BMI, 16,17 WHR, 16 TC, 13 HDL-C, 18 LDL-C, 19 BUN, blood creatinine, 20 and UAER 21,22 have certain associations with DR in diabetics. However, in our study, it appears that those related above are not risk factors for DR in prediabetics.…”

Section: Discussionmentioning

confidence: 96%

Prevalence and risk factors of diabetic retinopathy in Chongqing pre-diabetes patients

Chen

Zhao

Zhou

et al. 2012

Eye

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Purpose To investigate the prevalence of diabetic retinopathy (DR) and relative risk factors among Chongqing pre-diabetes patients. Methods A total of 750 participants were recruited in this cross-sectional study. All participants underwent a complete physical examination and an oral glucose-tolerance test. In all, 110 of the 125 newly diagnosed pre-diabetics and their healthy spouses as controls were examined with fluorescence fundus angiographies, and their blood with biochemical analyses. All the pre-diabetics with DR (23 subjects), 23 normal controls and 23 pre-diabetics without DR were compared for serum concentrations of regulated upon activation, normal T-expressed and secreted (RANTES). Student's t-test was used to compare continuous variables, and v 2 test and analysis of variance to compare proportions among groups. Multiple logistic regression models were used to determine the risk factors for DR in pre-diabetics. Results In all, 20.91% of the 110 pre-diabetics showed mild non-proliferative DR (NPDR). There was a statistically significant difference in serum concentrations of RANTES between pre-diabetics with and without DR (Po0.01), and also between pre-diabetics with DR and normal controls (Po0.01). However, age, body mass index, waist-hip ratio, triacylglycerol (TG), total cholesterol (TC), high-density lipoprotein-C, low-density lipoprotein-C, blood urea nitrogen, blood creatinine, and urine albumin excretion rate seemed to have no reliable relationship with DR in pre-diabetics (P40.05).

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Section: Discussionmentioning

confidence: 96%

Prevalence and risk factors of diabetic retinopathy in Chongqing pre-diabetes patients

Chen

Zhao

Zhou

et al. 2012

Eye

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“…First, any retinopathy [6,[35][36][37], and nephropathy [38,39] may also occur in persons without diabetes as these outcomes are related to non-glycaemic processes such as age, obesity, dyslipidaemia and hypertension [40,41], which are very common in the population. As such, it should not be surprising that some of these complications that are not specific to hyperglycaemia are seen at the relatively low levels of glycaemia observed in this study.…”

Section: Discussionmentioning

confidence: 99%

Relationship between glycated haemoglobin and microvascular complications: Is there a natural cut-off point for the diagnosis of diabetes?

et al. 2009

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Aims/hypothesis This study was designed to determine whether the relationship of glycated haemoglobin to diabetic microvascular complications shows any natural thresholds that could be useful in diagnosing diabetes. Methods We examined a population-based sample of 3,190 Malay adults aged 40-80 years in Singapore. The microvascular outcomes of interest were: (1) any retinopathy, defined from fundus photographs; (2) mild retinopathy, defined as in (1); (3) moderate retinopathy, defined as in (1); (4) chronic kidney disease, defined from estimated glomerular filtration rate; (5) micro-or macroalbuminuria, defined from urinary albumin to creatinine ratio; and (6) peripheral neuropathy, defined from neurothesiometer or monofilament sensory testing. Results Increasing HbA 1c was associated with all microvascular complications. The optimal cut-off points for detecting mild and moderate retinopathy were 6.6% (87.0% sensitivity, 77.1% specificity and area under the receiver operating characteristics [ROC] curve 0.899) and 7.0% (82.9% sensitivity, 82.3% specificity and area under ROC curve 0.904). The prevalences of mild and moderate retinopathy were <1% below the optimal cut-off points. For other complications, the association with HbA 1c was linear without evidence of a distinct threshold. Although ROC analysis for these other complications also suggested optimal cut-off points between 6.6% and 7.0%, the sensitivity at these cut-off points was considerably lower than for mild and moderate retinopathy, ranging from 31.8% to 66.5%. Conclusions/interpretation Higher levels of HbA 1c were associated with microvascular complications. Our data support use of an HbA 1c cut-off point of between 6.6 and 7.0% in diagnosing diabetes. Cut-off points in this range were best for the identification of individuals with mild and moderate retinopathy. Any retinopathy, chronic kidney disease, albuminuria and peripheral neuropathy are less well detected at these cut-off points.

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“…Previous studies have identified various risk factors for retinopathy in subjects without diabetes as a history of heart attack 6,9 , the presence of stroke 9,10 , SBP 6,11 , hypertension 6,7,9,[12][13][14][15] , BMI 6,8,11 , internal carotid arterial intima-media thickness 7,9 , carotid arterial plaque 9 , age 8,16 , glucose intolerance 8 and dyslipidemia 11 . These findings suggest that retinopathy and cardiovascular diseases (CVD) share a common pathophysiology.…”

Section: Discussionmentioning

confidence: 99%

“…The prevalence of retinopathy has been reported to be 4. [8][9][10][11][12][13][14][15].5% in subjects without diabetes. However, these reports used different definitions of diabetes, such as FPG alone, a combination of FPG and 2-h PG, non-fasting glucose, current use of diabetes medications or a self-reported history of diabetes.…”

Section: Introductionmentioning

confidence: 94%

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Prevalence of retinopathy and its risk factors in a Japanese population

Fukushima

Nakagami

Suto

et al. 2013

J of Diabetes Invest

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Aims/Introduction: To determine the prevalence and risk factors of retinopathy and validity of the current diagnostic cut-offs for diabetes by using data of health check-up examinees. Materials and Methods: The study comprises 1,864 Japanese who participated in the general health check-up program and did not have a previous history of cardiovascular disease. Non-mydriatic 45°digital fundus photographs were taken twice annually. Multivariate logistic regression model was used to identify risk factors for retinopathy in participants without previously diagnosed diabetes. Results: The overall prevalence of retinopathy in participants with and without previously diagnosed diabetes were 23.3% (28/120) and 4.2% (74/1,744), respectively. Univariate logistic regression analysis identified age, systolic blood pressure (SBP), fasting plasma glucose (FPG) and hemoglobin A1c (HbA 1c ) as risk factors for retinopathy. Multivariate logistic regression analysis showed that FPG or both HbA 1c and SBP were significant, positive and independent risk factors for retinopathy. The prevalence of retinopathy increased with deterioration of glucose categories (P < 0.001 for FPG or HbA 1c ). However, a statistically significant increased risk of retinopathy remained only in participants with FPG ≥ 7.0 mmol/L or HbA1c ≥ 6.5% compared with those with the lowest quartile of glucose in the participants without previously diagnosed diabetes after adjusting for age and SBP. Conclusions: The prevalence of retinopathy was 4.2%, and FPG or both HbA 1c and SBP were positive and independent risk factors for retinopathy in health check-up examinees without previously diagnosed diabetes. The FPG 7.0 mmol/L or HbA 1c 6.5% seems to be appropriate to diagnose diabetes in view of its association with retinopathy. (J Diabetes Invest,

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Retinopathy in Persons without Diabetes: The Los Angeles Latino Eye Study

Abstract: The data suggest that the prevalence of retinopathy in nondiabetic individuals among Latinos of primarily Mexican ancestry is significant. Independent risk indicators for retinopathy in the study population are hypertension, male gender, current smoking status, and obesity.

Cited by 32 publications

References 30 publications

Prevalence and risk factors of diabetic retinopathy in Chongqing pre-diabetes patients

Prevalence and risk factors of diabetic retinopathy in Chongqing pre-diabetes patients

Relationship between glycated haemoglobin and microvascular complications: Is there a natural cut-off point for the diagnosis of diabetes?

Prevalence of retinopathy and its risk factors in a Japanese population

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