Risk of diabetic retinopathy and retinal neurodegeneration in individuals with type 2 diabetes: Beichen Eye Study

Abstract

ObjectiveOur aim was to evaluate associations of different risk factors with odds of diabetic retinopathy (DR) diagnosis and retinal neurodegeneration represented by macular ganglion cell-inner plexiform layer (mGCIPL).MethodsThis cross-sectional study analyzed data from individuals aged over 50 years examined between June 2020 and February 2022 in the community-based Beichen Eye Study on ocular diseases. Baseline characteristics included demographic data, cardiometabolic risk factors, laboratory findings, and medications at enrollment. Retinal thickness in both eyes of all participants was measured automatically via optical coherence tomography. Risk factors associated with DR status were investigated using multivariable logistic regression. Multivariable linear regression analysis was performed to explore associations of potential risk factors with mGCIPL thickness.ResultsAmong the 5037 included participants with a mean (standard deviation, SD) age of 62.6 (6.7) years (3258 women [64.6%]), 4018 (79.8%) were control individuals, 835 (16.6%) were diabetic individuals with no DR, and 184 (3.7%) were diabetic individuals with DR. The risk factors significantly associated with DR status were family history of diabetes (odds ratio [OR], 4.09 [95% CI, 2.44-6.85]), fasting plasma glucose (OR, 5.88 [95% CI, 4.66-7.43]), and statins (OR, 2.13 [95% CI, 1.03-4.43]) relative to the control individuals. Compared with the no DR, diabetes duration (OR, 1.17 [95% CI, 1.13-1.22]), hypertension (OR, 1.60 [95% CI, 1.26-2.45]), and glycated hemoglobin A1C (HbA1c) (OR, 1.27 [95% CI, 1.00-1.59]) were significantly correlated with DR status. Furthermore, age (adjusted β = -0.19 [95% CI, -0.25 to -0.13] μm; P < 0.001), cardiovascular events (adjusted β = -0.95 [95% CI, -1.78 to -0.12] μm; P = 0.03), and axial length (adjusted β = -0.82 [95% CI, -1.29 to -0.35] μm; P = 0.001) were associated with mGCIPL thinning in diabetic individuals with no DR.ConclusionMultiple risk factors were associated with higher odds of DR development and lower mGCIPL thickness in our study. Risk factors affecting DR status varied among the different study populations. Age, cardiovascular events, and axial length were identified as potential risk factors for consideration in relation to retinal neurodegeneration in diabetic patients.

The causal effect of hypertension, intraocular pressure, and diabetic retinopathy: a Mendelian randomization study

“…Although it is generally accepted that hypertension is associated with the risk of DR, there are conflicting views on this relationship in previous studies. Numerous studies have confirmed that hypertension can be a potential risk factor for DR. A cross-sectional study by Yang et al revealed that the progression of diabetes, hypertension, and HbA1c are independent risk factors for DR formation in patients with diabetes but do not impact the diagnostic rate of DR in the general population (22). Some RCTs have proved that good regular blood pressure control is advantageous for the emergence of DR. Higher blood pressure level may be associated with the occurrence and progress of DR; however, mildly elevated hypertension does not significantly impact the development of DR (23).…”

Socio-behavioral determinants of health-related quality of life among patients with type 2 diabetes: comparison between 2015 and 2018

“…Individuals with T2D have an increased risk of developing various complications such as cardiovascular disease, neuropathy and retinopathy, which can significantly affect their quality of life [ 9 ]. However, effective management of T2D requires an understanding of the socio-behavioral determinants that influence health-related quality of life [ 10 ].…”