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Shrateh O, Abdelhafez M, Ereqat S, Dein L, Iriqat S. Identification of Risk Factors for the Development of Diabetic Retinopathy Among Palestinian Adults With Type 2 Diabetes Mellitus: A Cross-Sectional Study. Endocrinol Diabetes Metab 2024; 7:e494. [PMID: 38874277 PMCID: PMC11177287 DOI: 10.1002/edm2.494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/19/2024] [Accepted: 05/07/2024] [Indexed: 06/15/2024] Open
Abstract
INTRODUCTION Although risk factors linked to diabetic retinopathy (DR) among patients with Type 2 diabetes mellitus (T2DM) have been extensively studied globally, the specific determinants of these factors in relation to DR in Palestine are presently not well understood. METHODS This retrospective cross-sectional study included patients who underwent DR screening with a fundus camera (VersaCam a). The study included patients aged ≥18 with T2DM, excluding those with other types of diabetes or a history of malignancies. Univariable and multivariable logistic regressions were used to identify factors associated with DR. RESULTS A total of 1163 patients with T2DM were included in this study. Of these, 211 (18.1%) patients were classified in the DR group, 761 (65.4%) in the no DR group and 191 (16.4%) were ungradable. Among the included patients, 434 (37.3%) were male. A secondary level of education or higher and a BMI ≥30 kg/m2, compared with <25 kg/m2, were independently and inversely associated with DR, with odds ratios (ORs) of 0.46 (p < 0.001) and 0.58 (p = 0.046), respectively. A 5-year increase in the duration of T2DM correlated with 45% higher odds of having DR (p < 0.001). Patients with DR were more likely to have HbA1c >7%, be physically inactive and use insulin, with ORs of 1.63 (p = 0.02), 2.05 (p < 0.001) and 1.53 (p = 0.03), respectively. Age, gender, occupational status, hypertension and hyperlipidaemia were not independent predictors of DR (p < 0.05). CONCLUSION Longer duration of T2DM, HbA1c >7%, physical inactivity and insulin use were all independently associated with the presence of DR. Furthermore, a secondary or higher educational level and obesity demonstrated independent and inverse associations with the development of DR.
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Affiliation(s)
| | - Mohammad Abdelhafez
- Department of Internal Medicine, Faculty of MedicineAl‐Quds UniversityJerusalemPalestine
| | - Suheir Ereqat
- Biochemistry and Molecular Biology Department, Faculty of MedicineAl‐Quds UniversityJerusalemPalestine
| | | | - Salam Iriqat
- Ocular Inflammatory Disease DepartmentSt John Eye HospitalJerusalemPalestine
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Smoking and diabetes: sex and gender aspects and their impact on vascular diseases. Can J Cardiol 2023; 39:681-692. [PMID: 36702239 DOI: 10.1016/j.cjca.2023.01.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 01/24/2023] Open
Abstract
Smoking and diabetes mellitus (DM) have been identified as two major cardiovascular risk factors for many years. In the field of cardiovascular diseases, considering sex differences, or gender differences, or both has become an essential element in moving toward equitable and quality healthcare. We reviewed the impact of sex or gender on the link between smoking and DM. The risk of type 2 DM (T2DM) due to smoking has been established in both sexes at the same level. As is the case in the general population, the prevalence of smoking in those with DM is higher in men than in women, although the decrease in smoking observed in recent years is more pronounced in men than in women. Regarding chronic DM complications, smoking is an independent risk factor for all-cause mortality, as well as macrovascular and microvascular complications, in both sexes. Nevertheless, in T2DM, the burden of smoking appears to be greater in women than in men for coronary heart disease morbidity, women having a 50% higher risk of fatal coronary event. Women are more dependent to nicotine, cumulate psychosocial barriers to quitting smoking, and are more likely to gain weight, which might make it more difficult for them to quit smoking. Smoking cessation advice and treatments should take into account gender differences to improve the success and long-term maintenance of abstinence in people with and without DM. This might include interventions that address emotions and stress in women or designed to reach specific populations of men.
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Kang HM, Hasanuzzaman M, Kim SW, Koh HJ, Lee SC. Elevated aqueous endothelin-1 concentrations in advanced diabetic retinopathy. PLoS One 2022; 17:e0268353. [PMID: 35544533 PMCID: PMC9094525 DOI: 10.1371/journal.pone.0268353] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 04/27/2022] [Indexed: 12/02/2022] Open
Abstract
Purpose Endothelin-1 (ET-1) is a potent vasoconstrictor which seems to be involved in the pathogenesis of diabetic retinopathy (DR). However, studies on intraocular ET-1 in DR have been limited. Thus, we investigated aqueous ET-1 levels in patients with DR. Methods A total 85 subjects were included in this prospective study. Those were classified into three groups: advanced DR group included those with severe nonproliferative DR or proliferative DR, whereas early DR group included those with mild nonproliferative DR or moderative nonproliferative DR. Those who underwent cataract surgery and had no concomitant ocular disease were included in the control group. Aqueous humor levels of ET-1 were obtained before intravitreal bevacizumab injection (IVB) and after 1 month for the DR patients, and at the time of cataract surgery for the control group. Results Advanced DR group included 40 eyes (47.1%), whereas early DR group did 19 eyes (22.4%), and control group (26 eyes, 30.5%). Mean aqueous ET-1 level was 10.1±4.1 pg/mL (6.0–21.0 pg/mL) in advanced DR group, 1.9±0.7 pg/mL (0.6–2.8 pg/mL) in early DR group, and 2.1±1.0 pg/mL (0.7–3.9 pg/mL) in control group (P < 0.001). Advanced DR group was further subdivided into severe nonproliferative DR (15 eyes, 12.8%) and proliferative DR (25 eyes, 34.3%). Mean aqueous ET-1 level was 10.1±4.3 pg/mL (6.0–20.1 pg/mL) in patients with severe nonproliferative DR, and 10.0±4.0 pg/mL (6.0–21.0 pg/mL) in those with proliferative DR (P = 0.928) at baseline. Mean ET-1 level at 1 month after intravitreal injection was 2.5±1.0 pg/mL (0.3–4.8 pg/mL) in patients with severe proliferative DR and 2.9±1.7 pg/mL (1.0–7.0 pg/mL) in those with proliferative DR (P = 0.443). Mean aqueous ET-1 level was significantly reduced in both groups (P < 0.001, respectively). Conclusion The mean aqueous ET-1 level was significantly higher in the eyes with advanced DR than those with early DR and the control group. The mean aqueous ET-1 level was significantly reduced after intravitreal injections in the advanced DR group. Based on our results, future studies on the exact role of ET-1 in the pathogenesis of DR and future implication for intervention would be helpful for managing DR.
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Affiliation(s)
- Hae Min Kang
- Quantitative method, Harvard TH Chan School of Public Health, Boston, Massachusetts, United States of America
- Catholic Kwandong University College of Medicine, Incheon, Republic of Korea
- * E-mail:
| | - Md. Hasanuzzaman
- Department of Pharmacology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - So Won Kim
- Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyoung Jun Koh
- Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sung Chul Lee
- Department of Ophthalmology, Konyang University Hospital, Daejeon, Republic of Korea
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Amer J, Suboh R, Abualrob M, Shaheen A, Abu Shanab AR. Risk Factors Associated With Diabetic Retinopathy: A Cross-Sectional Study Within Palestinian Patients in Northern West Bank. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2021; 2:736715. [PMID: 36994348 PMCID: PMC10012083 DOI: 10.3389/fcdhc.2021.736715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 09/21/2021] [Indexed: 11/13/2022]
Abstract
Risk factors associated with diabetes mellitus (DM) have been widely researched worldwide, but the determinants of these factors among diabetic retinopathy (DR) in Palestine are currently unclear. We aimed to assess the prevalence of DR among DM in Northern West Bank and identify factors associated with DR natural history. Patients with Type 2 diabetes (T2D) (n = 300, age > 18 years) from a main diabetic center covering all northern provinces of Palestine were enrolled to this cross-sectional research. Demographic information including age, sex, and duration of T2D was obtained. Moreover, HbA1C, BMI, hypertension (HTN), controlled T2D, current smoking, and total cholesterol level were assessed. Potential correlations between these factors and DR diagnosed by ophthalmologist were evaluated using different tests on SPSS version 22. Prevalence of DR among our population was 30%; 47.8% of these patients showed mild non-proliferative DR (NPDR), 23.3% moderate NPDR, 16.7% severe NPDR, and 12.2% proliferative DR (PDR). Univariate logistic regression analysis showed age (p = 0.007), HTN (p = 0.022), uncontrolled T2D (p = 0.025), and duration of T2D (<0.001) were mostly associated with DR while multivariate logistic regression showed duration of T2D as the major and solely risk factor for prevalence of DR (p < 0.0001) and were positively correlated with severities of NPDR and being a strong predictor in the PDR (p = 0.001). We identified several important risk factors that affect DR, which could assist to develop effective strategies for metabolic disease prevention among populations in Palestine. Furthermore, our data suggest a necessity to control sugar serum levels and HTN.
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Affiliation(s)
- Johnny Amer
- Physiology, Pharmacology & Toxicology Division, An-Najah National University, Nablus, Palestine
- *Correspondence: Johnny Amer,
| | - Raghad Suboh
- Physiology, Pharmacology & Toxicology Division, An-Najah National University, Nablus, Palestine
| | - Manar Abualrob
- Physiology, Pharmacology & Toxicology Division, An-Najah National University, Nablus, Palestine
| | - Amira Shaheen
- Division of Public Health, Department of Biomedical Sciences, An-Najah National University, Nablus, Palestine
| | - Abdul Raheem Abu Shanab
- Department of Applied and Allied Medical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
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Kim J, Seong H, Son KJ, Chung EJ. Declined incidence of patients treated for vision-threatening diabetic retinopathy in South Korea: a 12-year nationwide population-based study. Graefes Arch Clin Exp Ophthalmol 2021; 260:101-111. [PMID: 34410486 DOI: 10.1007/s00417-021-05365-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 10/20/2022] Open
Abstract
PURPOSE To determine the age- and sex-specific annual incidence rates of patients treated for VTDR and the factors associated with increased treatment rates in patients with type 2 diabetes mellitus (T2DM) in South Korea. METHODS This was a nationwide, retrospective, 12-year, population-based study. Patients aged over 30 years who were diagnosed with T2DM between 2006 and 2017 were included in this study. We evaluated the national health claims data acquired from the Korean National Health Insurance Service database. Main outcome measures were the annual incidence rates of patients treated for VTDR and the associated risk factors. RESULTS The age-adjusted annual incidence rate of patients treated for VTDR significantly decreased from 10.05 per 1000 T2DM patients in 2006 to 6.11 in 2017 (β = - 0.3192, P < 0.0001). The sex-adjusted annual incidence rate also significantly decreased in both men (β = - 0.2861, P < 0.0001) and women (β = - 0.3666, P < 0.0001). Cox hazard analysis showed that factors such as insulin use, young age, chronic kidney disease and male sex were significantly associated with increased rate of treatments for VTDR. In addition, the risk was lower for rural than for metropolitan residents. CONCLUSIONS Despite the increase in the number of T2DM patients in South Korea, the incidence rate of patients treated for VTDR decreases with early diagnosis and appropriate treatment. Therefore, it is important to detect and manage high-risk groups early to prevent visual impairment due to VTDR.
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Affiliation(s)
- Jiwon Kim
- Department of Ophthalmology, National Health Insurance Service Ilsan Hospital, #100 Ilsan-ro, Ilsandong-gu, Gyeonggi-do, 410-719, Goyang, Korea
| | - Hyojin Seong
- Department of Ophthalmology, National Health Insurance Service Ilsan Hospital, #100 Ilsan-ro, Ilsandong-gu, Gyeonggi-do, 410-719, Goyang, Korea.,Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
| | - Kang Ju Son
- Department of Research and Analysis, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Eun Jee Chung
- Department of Ophthalmology, National Health Insurance Service Ilsan Hospital, #100 Ilsan-ro, Ilsandong-gu, Gyeonggi-do, 410-719, Goyang, Korea.
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Seo JS, Cho YW, Seo SW, Kim SJ, Chung IY, Yoo WS. Microvasculature and Nerve Fiber Layer-Ganglion Cell Inner Plexiform Layer Thickness in Type 2 Diabetes. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2021. [DOI: 10.3341/jkos.2021.62.6.769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Hammoudi J, Bouanani NEH, Chelqi EH, Bentata Y, Nouayti H, Legssyer A, Ziyyat A. Diabetic retinopathy in the Eastern Morocco: Different stage frequencies and associated risk factors. Saudi J Biol Sci 2021; 28:775-784. [PMID: 33424367 PMCID: PMC7783821 DOI: 10.1016/j.sjbs.2020.11.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/28/2020] [Accepted: 11/01/2020] [Indexed: 11/22/2022] Open
Abstract
Diabetes is a major cause of morbidity and mortality worldwide. It can affect many organs and, over time, leads to serious complications. Diabetic retinopathy (DR), a specific ocular complication of diabetes, remains the leading cause of vision loss and vision impairment in adults. This work is the first in Eastern Morocco aimed at identifying the different stages of DR and to determine their frequencies and associated risk factors. It is a case-control study conducted from December 2018 to July 2019 at the ophthalmology department of Al-Irfane Clinic (Oujda). Data were obtained from a specific questionnaire involving 244 diabetic patients (122 cases with retinopathy vs 122 controls without retinopathy). All results were analyzed by the EPI-Info software. This study shows a predominance of proliferative diabetic retinopathy (PDR) with 57.4% of cases (uncomplicated proliferative diabetic retinopathy (UPDR): 23.8%; complicated proliferative diabetic retinopathy (CPDR): 33.6%). The non-proliferative diabetic retinopathy (NPDR) represents 42.6% (minimal NPDR: 8.2%; moderate NPDR: 26.2%; severe NPDR: 8.2%). The determinants of DR were insulin therapy, high blood pressure, poor glycemic control and duration of diabetes. Regarding the chronological evolution, retinopathy precedes nephropathy. Diabetic nephropathy (DN) was present in 10.6% of cases especially in patients with PDR. In summary, the frequency of PDR was higher than that of NPDR. DR appears before DN with a high frequency of DN in patients with PDR. Good glycemic control and blood pressure control, as well as early diagnosis are the major preventive measures against DR.
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Affiliation(s)
- Jamila Hammoudi
- Laboratoire de Bioressources, Biotechnologies, Ethnopharmacologie et Santé, Département de Biologie – Faculté des Sciences, Université Mohammed Premier, Oujda, Morocco
| | - Nour El Houda Bouanani
- Laboratoire de Bioressources, Biotechnologies, Ethnopharmacologie et Santé, Département de Biologie – Faculté des Sciences, Université Mohammed Premier, Oujda, Morocco
| | | | | | - Hamid Nouayti
- Laboratoire de Bioressources, Biotechnologies, Ethnopharmacologie et Santé, Département de Biologie – Faculté des Sciences, Université Mohammed Premier, Oujda, Morocco
| | - Abdelkhaleq Legssyer
- Laboratoire de Bioressources, Biotechnologies, Ethnopharmacologie et Santé, Département de Biologie – Faculté des Sciences, Université Mohammed Premier, Oujda, Morocco
| | - Abderrahim Ziyyat
- Laboratoire de Bioressources, Biotechnologies, Ethnopharmacologie et Santé, Département de Biologie – Faculté des Sciences, Université Mohammed Premier, Oujda, Morocco
- Corresponding author at: Laboratoire de Bioressources, Biotechnologies, Ethnopharmacologie et Santé, Département de Biologie – Faculté des Sciences, Université Mohammed 1er, BP 717, Boulevard Mohamed VI, 60000 Oujda, Morocco.
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Yao L, Wang X, Zhong Y, Wang Y, Wu J, Geng J, Zhou Y, Chen J, Guan P, Xu Y, Chen L, Liu L, Hu Y. The Triglyceride-Glucose Index is Associated with Diabetic Retinopathy in Chinese Patients with Type 2 Diabetes: A Hospital-Based, Nested, Case-Control Study. Diabetes Metab Syndr Obes 2021; 14:1547-1555. [PMID: 33859485 PMCID: PMC8043781 DOI: 10.2147/dmso.s294408] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 03/20/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND This study aimed to investigate the association between the triglyceride-glucose (TyG) index and diabetic retinopathy (DR) in Chinese patients with type 2 diabetes. METHODS In this nested case-control study, all diabetic participants were registered hospitalizations during 2012-2018, including 596 with DR as cases and three matching controls per case. DR was assessed using Early Treatment Diabetic Retinopathy Study criteria. The TyG index was calculated: Ln (fasting blood glucose [mg/dL] × fasting triglycerides [mg/dL] ÷ 2). Multivariate logistic regression, a receiver-operating characteristic (ROC) curve, linear regression models, and mediation analysis were used to explore associations. RESULTS The TyG index was lower in DR and decreased as its severity advanced among 2,112 subjects (P=0.005). After confounders (sex, duration of diabetes, use of antidiabetic agents, heart rate, systolic blood pressure, pulse pressure, height, weight, body-mass index, and glycated hemoglobin) had been accounted for, there were significant associations between the TyG index and any-severity DR (OR 0.83, 95% CI 0.73-0.95; P=0.006), as well as vision-threatening DR (VTDR; OR 0.53, 95% CI 0.36-0.76; P=0.001). ROC analysis indicated that the TyG index showed significant discriminatory ability in any-severity DR (area under curve [AUC] 0.534, P=0.015) and VTDR (AUC 0.624, P=0.001). CONCLUSION The TyG index was associated with the presence and severity of DR. Our findings suggest that the TyG index may become a useful biomarker in evaluating and following the presence of DR and VTDR.
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Affiliation(s)
- Litong Yao
- Department of Breast Surgery, First Affiliated Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
- China Medical University, Shenyang, 110001, People’s Republic of China
| | - Xinyu Wang
- China Medical University, Shenyang, 110001, People’s Republic of China
| | - Yifan Zhong
- Department of Ophthalmology, First Affiliated Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
| | - Yan Wang
- Department of Radiology, General Hospital of Liaohe Oil Field, Panjin, 124010, People’s Republic of China
| | - Jingyang Wu
- Department of Ophthalmology, First Affiliated Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
| | - Jin Geng
- Department of Ophthalmology, First Affiliated Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
| | - Yun Zhou
- Department of Ophthalmology, First Affiliated Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
| | - Jun Chen
- Department of Ophthalmology, First Affiliated Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
| | - Peng Guan
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, 110122, People’s Republic of China
| | - Yingying Xu
- Department of Breast Surgery, First Affiliated Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
| | - Lei Chen
- Department of Ophthalmology, First Affiliated Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
| | - Lei Liu
- Department of Ophthalmology, First Affiliated Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
- Correspondence: Lei Liu; Yuedong Hu Department of Ophthalmology, First Affiliated Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, Liaoning Province, People’s Republic of ChinaTel/Fax +86-24-8328-2277 Email ;
| | - Yuedong Hu
- Department of Ophthalmology, First Affiliated Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
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Association between daily sunlight exposure duration and diabetic retinopathy in Korean adults with diabetes: A nationwide population-based cross-sectional study. PLoS One 2020; 15:e0237149. [PMID: 32764774 PMCID: PMC7413474 DOI: 10.1371/journal.pone.0237149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 07/21/2020] [Indexed: 11/21/2022] Open
Abstract
Purpose To investigate the association between daily sunlight exposure duration and diabetic retinopathy in Korean adults with diabetes. Methods This study used data from the 2008–2011 Korea National Health and Nutrition Examination Survey. Overall, 1,089 patients with diabetes aged >40 years were included. The duration of daily sunlight exposure was assessed via health interviews. Comprehensive ophthalmic evaluations, including standard retinal fundus photography after pupil dilation, were conducted. Diabetic retinopathy was graded using the modified Airlie House Classification. Multivariate logistic regression analysis was performed to analyze the association between daily sunlight exposure duration and the diagnosis of diabetic retinopathy and non-proliferative diabetic retinopathy. Results The risk of diabetic retinopathy was 2.66 times higher in the group with ≥5 h of daily sunlight exposure than in the group with less exposure after adjusting for risk factors such as duration of diabetes, serum hemoglobin A1c level, hypertension, and dyslipidemia (P = 0.023). Furthermore, the risk of non-proliferative diabetic retinopathy was 3.13 times higher in the group with ≥5 h of daily sunlight exposure than in the group with less exposure (P = 0.009). In patients with diabetes for <10 years, the risks of diabetic retinopathy and non-proliferative diabetic retinopathy were 4.26 and 4.82 times higher in the group with ≥5 h of daily sunlight exposure than the group with less exposure, respectively (P < 0.05). Conclusions This study revealed that sunlight exposure for ≥5 h a day was significantly associated with an increased risk of diabetic retinopathy and non-proliferative diabetic retinopathy in Korean patients with diabetes. The risks were significantly higher in patients with diabetes for <10 years. Therefore, reducing daily sunlight exposure could be an early preventive strategy against diabetic retinopathy in people with diabetes.
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Chen C, Sun Z, Xu W, Tan J, Li D, Wu Y, Zheng T, Peng D. Associations between alcohol intake and diabetic retinopathy risk: a systematic review and meta-analysis. BMC Endocr Disord 2020; 20:106. [PMID: 32680496 PMCID: PMC7368775 DOI: 10.1186/s12902-020-00588-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 07/07/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Some previous studies have reported inconsistent results on the association between alcohol intake and diabetic retinopathy (DR) risk. This study aimed to evaluate the potential effects of alcohol intake on subsequent DR risk using a meta-analytic approach. METHODS Three electronic databases (PubMed, EmBase, and the Cochrane library) were systematically searched for observational studies from their inception till November 2019. The pooled odds ratio (OR) with 95% confidence interval (CI) were applied for the summary effect estimate using a random-effects model. RESULTS A total of 15 studies (5 cohort studies, 4 case-control studies, and 6 cross-sectional studies) with 37,290 participants and 12,711 DR cases were selected for the final meta-analysis. The pooled OR indicated no significant association between alcohol intake and DR risk (OR: 0.91; 95%CI: 0.78-1.06; P = 0.225), irrespective of the studies being pooled cohort (OR: 0.95; 95%CI: 0.66-1.36; P = 0.761), case-control (OR: 0.97; 95%CI: 0.77-1.23; P = 0.818), or cross-sectional (OR: 0.86; 95%CI: 0.69-1.08; P = 0.190) ones. However, this association might have been affected by the type of diabetes mellitus and the adjusted status. CONCLUSION The results of this study showed that the potential impact of alcohol intake on DR risk may differ according to the type of diabetes mellitus and adjusted status. Further large-scale, prospective cohort studies should be conducted to verify the findings of this study and to evaluate DR risk in relation to the dose and type of alcohol intake.
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Affiliation(s)
- Chen Chen
- Shanghai Jing 'an District Jiangning Road Community Health Service Center, Shanghai, China
- Shanghai Jing 'an District Pengpuxincun Community Health Service Center, No.15 Pingshun Road, Jing 'an District, Shanghai, 200435, China
| | - Zhaojun Sun
- Shanghai Jing 'an District Pengpuxincun Community Health Service Center, No.15 Pingshun Road, Jing 'an District, Shanghai, 200435, China
| | - Weigang Xu
- Shanghai Jing 'an District Pengpuxincun Community Health Service Center, No.15 Pingshun Road, Jing 'an District, Shanghai, 200435, China
| | - Jun Tan
- Shanghai Jing 'an District Pengpuxincun Community Health Service Center, No.15 Pingshun Road, Jing 'an District, Shanghai, 200435, China
| | - Dan Li
- Shanghai Jing 'an District Pengpuxincun Community Health Service Center, No.15 Pingshun Road, Jing 'an District, Shanghai, 200435, China
| | - Yiting Wu
- Shanghai Jing 'an District Pengpuxincun Community Health Service Center, No.15 Pingshun Road, Jing 'an District, Shanghai, 200435, China
| | - Ting Zheng
- Shanghai Jing 'an District Pengpuxincun Community Health Service Center, No.15 Pingshun Road, Jing 'an District, Shanghai, 200435, China
| | - Derong Peng
- Shanghai Jing 'an District Pengpuxincun Community Health Service Center, No.15 Pingshun Road, Jing 'an District, Shanghai, 200435, China.
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Singh SS, Roeters-van Lennep JE, Lemmers RFH, van Herpt TTW, Lieverse AG, Sijbrands EJG, van Hoek M. Sex difference in the incidence of microvascular complications in patients with type 2 diabetes mellitus: a prospective cohort study. Acta Diabetol 2020; 57:725-732. [PMID: 32025877 PMCID: PMC7220974 DOI: 10.1007/s00592-020-01489-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 01/21/2020] [Indexed: 12/17/2022]
Abstract
AIMS Type 2 diabetes mellitus is a major cause of death and disability due to its long-term macro- and microvascular diseases. Although women with type 2 diabetes have more macrovascular diseases, it is unclear whether there are sex differences in the occurrence of microvascular disease. The aim of our study was to investigate sex differences in the incidence of microvascular complications in type 2 diabetes. METHODS Analyses were performed in the DiaGene study, a prospective cohort study for complications of type 2 diabetes, collected in the city of Eindhoven, the Netherlands (n = 1886, mean follow-up time = 6.93 years). Cox proportional hazard models adjusted for risk factors for complications (age, smoking, hypertension, dyslipidemia, HbA1c and duration of type 2 diabetes) were used to analyze the incidence of microvascular complications in men and women. RESULTS The incidence of microalbuminuria was significantly higher in men (HR microalbuminuria 1.64 [CI 1.21-2.24], p = 0.002). Additionally, men are more likely to develop two or three microvascular complications compared to women (OR 2.42 [CI 1.69-3.45], p < 0.001). CONCLUSIONS This study shows that men with type 2 diabetes are more likely to develop microvascular complications, especially microalbuminuria. Furthermore, men seem to have a higher chance of developing multiple microvascular complications. Our results highlight that men and women may not benefit to a similar extent from current treatment approaches to prevent diabetes-related microvascular diseases.
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Affiliation(s)
- Sunny S Singh
- Department of Internal Medicine, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Internal Medicine, Maxima Medical Center, Eindhoven, The Netherlands
| | | | - Roosmarijn F H Lemmers
- Department of Internal Medicine, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Aloysius G Lieverse
- Department of Internal Medicine, Maxima Medical Center, Eindhoven, The Netherlands
| | - Eric J G Sijbrands
- Department of Internal Medicine, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Mandy van Hoek
- Department of Internal Medicine, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands.
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Lee CH, Seo YS. Intraocular Pressure: Intravitreal Preservative-free Triamcinolone Injection in Diabetic Macular Edema and Branch Retinal Vein Occlusion. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2020. [DOI: 10.3341/jkos.2020.61.2.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Chan Ho Lee
- Department of Ophthalmology, Dankook University College of Medicine, Cheonan, Korea
| | - Young Seung Seo
- Department of Ophthalmology, Dankook University College of Medicine, Cheonan, Korea
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13
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Ren C, Liu W, Li J, Cao Y, Xu J, Lu P. Physical activity and risk of diabetic retinopathy: a systematic review and meta-analysis. Acta Diabetol 2019; 56:823-837. [PMID: 30900027 DOI: 10.1007/s00592-019-01319-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 03/05/2019] [Indexed: 01/28/2023]
Abstract
AIMS Diabetic retinopathy (DR) is an important microvascular complication of diabetes mellitus (DM) and a leading cause of visual impairment and blindness among people of working age. Physical activity (PA) or exercise is critical and beneficial for DM patients, whereas studies evaluating the relationship between PA and DR have yielded inconsistent and inconclusive results. The American Diabetes Association's "Standards of Medical Care in Diabetes" has also pointed out the indeterminate roles of PA in DR prevention. The purpose of this systematic review and meta-analysis was to explore the association between PA and DR risk. METHODS Medline (accessed by PubMed), EmBase, and Cochrane Library were systematically searched for studies up to June 2018, and the reference lists of the published articles were searched manually. The association between PA and DR risk was assessed using random-effect meta-analysis. RESULTS Twenty-two studies were included in this meta-analysis. PA was found to have a protective association with DR [risk ratio (RR) = 0.94, 95% confidence interval (95% CI) 0.90-0.98, p = 0.005] in diabetic patients, and the impact was more pronounced on vision-threatening DR (RR = 0.89, 95% CI 0.80-0.98, p = 0.02). Sedentary behavior could increase the risk of DR (RR = 1.18, 95% CI 1.01-1.37, p = 0.04). Moderate-intensity PA was likely to have a slight protective effect (RR = 0.76, 95% CI 0.58-1.00, p = 0.05). CONCLUSION PA is associated with lower DR risk, and more studies should focus on the causality between them.
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Affiliation(s)
- Chi Ren
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, People's Republic of China
| | - Weiming Liu
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, People's Republic of China
| | - Jianqing Li
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, People's Republic of China
| | - Yihong Cao
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, People's Republic of China
| | - Jiayi Xu
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, People's Republic of China
| | - Peirong Lu
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, People's Republic of China.
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Zhong Y, Yue S, Wu J, Guan P, Zhang G, Liu L, Chen L. Association of the Serum Total Cholesterol to Triglyceride Ratio with Diabetic Retinopathy in Chinese Patients with Type 2 Diabetes: A Community-Based Study. Diabetes Ther 2019; 10:597-604. [PMID: 30758833 PMCID: PMC6437234 DOI: 10.1007/s13300-019-0579-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION The relationship of total cholesterol (TC) or triglyceride (TG) to diabetic retinopathy (DR) has proven difficult to determine. In addition, there is no report of any study of the correlation between the TC/TG ratio and DR. This study was therefore undertaken to investigate the relationship between the TC/TG ratio and DR in Chinese adults with type 2 diabetes mellitus. METHODS A community-based study was conducted from August to October 2014 in Fengyutan, Shenyang, China. DR was assessed based on the modified Airlie House classification of DR. Multivariable logistic regression models were used to evaluate the association between the TC/TG ratio and the presence of DR. RESULTS Among the 420 diabetic participants in the study (157 men; mean (SD) age 61.7 (10.0) years), 76 (18.1%) presented with DR. When the TC/TG ratio was analyzed categorically, participants with T2DM in tertile 2 (i.e., TC/TG 2.91-4.00) were more likely (OR 2.01; 95% CI 1.01-3.99) to suffer from DR than patients in tertile 1 (i.e., TC/TG < 2.91) in multivariable models. Similarly, participants in tertile 3 (TC/TG > 4.00) were more likely (OR 2.59; 95% CI 1.11-3.14; P = 0.011) to suffer from DR than patients in tertile 1. This association persisted when the TC/TG ratio was analyzed continuously (P = 0.014). CONCLUSION We found a novel positive association between TC/TG ratio and presence of DR in Chinese individuals with T2DM. Although longitudinal data are needed, this finding contributes to the accumulating evidence that a high TC/TG ratio may be implicated in DR.
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Affiliation(s)
- Yifan Zhong
- Department of Ophthalmology, The First Affiliated Hospital of China Medical University, Shenyang, 110001, China
| | - Song Yue
- Department of Ophthalmology, The First Affiliated Hospital of China Medical University, Shenyang, 110001, China
| | - Jingyang Wu
- Department of Ophthalmology, The First Affiliated Hospital of China Medical University, Shenyang, 110001, China
| | - Peng Guan
- Department of Epidemiology, School of Public Health, China Medical University, Taichung, 110122, China
| | - Guisen Zhang
- Department of Ophthalmology, Hohhot Chao Ju Eye Hospital, Hohhot, 010000, China
| | - Lei Liu
- Department of Ophthalmology, The First Affiliated Hospital of China Medical University, Shenyang, 110001, China.
| | - Lei Chen
- Department of Ophthalmology, The First Affiliated Hospital of China Medical University, Shenyang, 110001, China
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15
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Yoon JS, Baek SK, Lee YH. Risk Factor Analysis of Diabetic Retinopathy Diagnosed with Non-mydriatic Fundus Camera: KNHANES V. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2019. [DOI: 10.3341/jkos.2019.60.6.555] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jung Suk Yoon
- Department of Ophthalmology, Konyang University College of Medicine, Daejeon, Korea
| | - Seung-Kook Baek
- Myunggok Eye Research Center, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea
| | - Young Hoon Lee
- Department of Ophthalmology, Konyang University College of Medicine, Daejeon, Korea
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Loprinzi PD, Edwards MK, Frith E. Review of the literature examining the association between physical activity and retinopathy. PHYSICIAN SPORTSMED 2018; 46:123-128. [PMID: 29157070 DOI: 10.1080/00913847.2018.1407619] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The main aim of this review was to evaluate the association between physical activity and retinopathy. Secondary aims included evaluating the association between sedentary behavior and retinopathy, and evaluating the association between physical activity/sedentary behavior on health outcomes among patients with existing retinopathy. Twenty-one articles met our criteria for inclusion in this review. Among the 19 studies evaluating the main aim (physical activity and retinopathy), 53% (n = 10/19) demonstrated evidence of a favorable (inverse) association between physical activity and retinopathy, 42% (n = 8/19) reported a null association physical activity and retinopathy, and 5% (n = 1/19) presented evidence for a detrimental association between physical activity and retinopathy. Regarding the secondary aims, one study demonstrated a detrimental association between sedentary behavior and retinopathy. Similarly, one study demonstrated that physical activity was protective against early mortality among those with mild retinopathy. This review identifies an 'indeterminate' association between physical activity and retinopathy. Too few studies evaluated the association between sedentary behavior and retinopathy or the effects of physical activity on health outcomes among those with existing retinopathy.
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Affiliation(s)
- Paul D Loprinzi
- a Physical Activity Epidemiology Laboratory, Exercise Psychology Laboratory, Department of Health, Exercise Science and Recreation Management , The University of Mississippi , University , MS , USA
| | - Meghan K Edwards
- a Physical Activity Epidemiology Laboratory, Exercise Psychology Laboratory, Department of Health, Exercise Science and Recreation Management , The University of Mississippi , University , MS , USA
| | - Emily Frith
- a Physical Activity Epidemiology Laboratory, Exercise Psychology Laboratory, Department of Health, Exercise Science and Recreation Management , The University of Mississippi , University , MS , USA
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17
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Diet and risk of diabetic retinopathy: a systematic review. Eur J Epidemiol 2017; 33:141-156. [DOI: 10.1007/s10654-017-0338-8] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 11/27/2017] [Indexed: 12/11/2022]
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18
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Maugeri G, D'Amico AG, Rasà DM, La Cognata V, Saccone S, Federico C, Cavallaro S, D'Agata V. Nicotine promotes blood retinal barrier damage in a model of human diabetic macular edema. Toxicol In Vitro 2017; 44:182-189. [PMID: 28689815 DOI: 10.1016/j.tiv.2017.07.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 05/17/2017] [Accepted: 07/05/2017] [Indexed: 12/20/2022]
Abstract
More than 1 billion world's population actively smokes tobacco containing the bioactive component nicotine (NT). The biological role of this molecule is mediated through the activation of nicotinic cholinergic receptors, widely distributed in various human tissues including retinal pigmented epithelium. The long-term assumption of NT contributes to several diseases development such as diabetic retinopathy. The major complication of this pathology is the diabetic macular edema (DME), characterized by macular area thinning and blood-retinal barrier (BRB) breakdown. Retinal hyperglycemic/hypoxic microenvironment represents one of the main factors favoring DME progression by eliciting the hypoxia-inducible factors (HIFs) expression. The latter induce new vessels formation by stimulating cellular secretion of vascular endothelial growth factor (VEGF). The etiology of DME is multifactorial, but little is known about the risk factors linked to cigarette smoking, in particular to nicotine's contribution. In the present study, we have investigated the NT role in a model, in vitro, of DME, by evaluating its effect on outer BRB permeability and HIFs/VEGF expression following exposure to hyperglycemic/hypoxic insult. Our results have demonstrated that this compound alters outer BRB integrity exposed to high glucose and low oxygen pressure microenvironment by upregulating HIF-1α/HIF-2α, VEGF expression and ERK1/2 phosphorylation. These data have suggested that NT may play a negative role in active smokers affected by DME.
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Affiliation(s)
- Grazia Maugeri
- Section of Human Anatomy and Histology, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Agata Grazia D'Amico
- Section of Human Anatomy and Histology, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy; Department of Human Science and Promotion of Quality of Life, San Raffaele Open University of Rome, Italy
| | - Daniela Maria Rasà
- Section of Human Anatomy and Histology, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Valentina La Cognata
- Section of Human Anatomy and Histology, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy; Institute of Neurological Sciences, National Research Council, Catania, Italy
| | - Salvatore Saccone
- Section of Animal Biology, Department of Biological, Geological and Environmental Sciences, University of Catania, Italy
| | - Concetta Federico
- Section of Animal Biology, Department of Biological, Geological and Environmental Sciences, University of Catania, Italy
| | | | - Velia D'Agata
- Section of Human Anatomy and Histology, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.
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Han JY, Kim YC. Analysis of Fluorescein Angiography and Optical Coherence Tomography in Acute Cerebral Infarction Patients. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2017. [DOI: 10.3341/jkos.2017.58.8.930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jung Yeob Han
- Department of Ophthalmology, Keimyung University School of Medicine, Daegu, Korea
| | - Yu Cheol Kim
- Department of Ophthalmology, Keimyung University School of Medicine, Daegu, Korea
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20
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Kim SY, Jeong IW, Yang YS, Choi CW. Changes of the Individual Retinal Layer Thickness in Non-proliferative Diabetic Retinopathy in Type 2 Diabetes. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2017. [DOI: 10.3341/jkos.2017.58.12.1376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Sang Yeop Kim
- Department of Ophthalmology, Wonkwang University School of Medicine, Iksan, Korea
- Institute of Wonkwang Medical Science, Wonkwang University, Iksan, Korea
| | - Il Won Jeong
- Department of Ophthalmology, Wonkwang University School of Medicine, Iksan, Korea
- Institute of Wonkwang Medical Science, Wonkwang University, Iksan, Korea
| | - Yun Sik Yang
- Department of Ophthalmology, Wonkwang University School of Medicine, Iksan, Korea
- Institute of Wonkwang Medical Science, Wonkwang University, Iksan, Korea
| | - Chang Wook Choi
- Department of Ophthalmology, Wonkwang University School of Medicine, Iksan, Korea
- Institute of Wonkwang Medical Science, Wonkwang University, Iksan, Korea
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21
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Murthy GVS, Das T. Diabetic care initiatives to prevent blindness from diabetic retinopathy in India. Indian J Ophthalmol 2016; 64:50-4. [PMID: 26953024 PMCID: PMC4821122 DOI: 10.4103/0301-4738.178152] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
It is estimated that 65 million (17%) of 382 million persons with diabetes mellitus (DM) globally reside in India. While globally 35% persons with DM have diabetic retinopathy (DR), this proportion is reportedly lower in India, other countries in South Asia and China. We reviewed published data from 2008 onwards from PubMed, which ascertained DR in population-based representative samples. We also reviewed the risk factors for DR, on awareness regarding eye complications and on accessing an eye examination. Thirteen research studies have reported on the prevalence of DR among persons with DM; this prevalence was lower than the global level in China, India, and Nepal. Eleven studies reported DR risk factors association. The duration of diabetes and level of glycemic control were universally acknowledged DR risk factors. We identified 7 studies in the Asia region that researched the level of awareness about diabetes eye complications and the practice of accessing an eye examination. Excepting 1 study in China, others reported a significant proportion being aware that diabetes leads to eye complications. But the awareness was not translated into a positive practice-most studies reported only 20-50% of the persons with diabetes actually having had their eyes examined. The present review highlights the observation that the risk factors for DR need an integrated diabetic care pathway where the eye care team has to work in close collaboration and partnership with a diabetic care team has to reduce the risk of blindness from DR.
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Affiliation(s)
- G V S Murthy
- Indian Institute of Public Health, Public Health Foundation of India; Department of Clinical Research, Public Health Eye Care and Disability, International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK,
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Lima VC, Cavalieri GC, Lima MC, Nazario NO, Lima GC. Risk factors for diabetic retinopathy: a case-control study. Int J Retina Vitreous 2016; 2:21. [PMID: 27847639 PMCID: PMC5088444 DOI: 10.1186/s40942-016-0047-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 09/06/2016] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Diabetic retinopathy (DR) is the major cause of blindness among working age adults. The aim of the study was to investigate risk factors for development of DR. METHODS A case-control study was performed based on data from 240 individuals (80 cases and 160 controls) attending the Outpatient Specialty Clinic of the University of South Santa Catarina (UNISUL), between Mar/2010 and May/2014. Data collection occurred through review of medical charts for presence or absence of DR, determined by an ophthalmologist. Study protocol included demographic characteristics, metabolic control, diabetes mellitus (DM) profile and comorbidities. Statistical analysis used Chi square test for qualitative variables and multivariate logistic regression analysis to select independent variables (SPSS®18.0 software). Odds ratio (OR) was used as measure of association. The study was approved by research ethics committee of UNISUL. RESULTS Mean age of group case was 59.5 years with a slight female predominance. Gender, age, body mass index were not associated with outcome. Individuals with poor glycemic control were more likely to DR (OR 3.83; 95 % CI 1.57-9.37). It was observed a positive relationship between duration of DM and DR, with higher chances in 11-15 years of disease (OR 7.52, 95 % CI 3.03-18.68) and >15 years (OR 9.01, 95 % CI 3.58-22.66). Regarding comorbidities, only diabetic nephropathy showed higher chance for DR (OR 3.32; 95 % CI 1.62-6.79). CONCLUSIONS Diabetic patients after 10 years of disease with poor glycemic control and nephropathy have a higher chance of DR.
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Affiliation(s)
- Vinícius Carriero Lima
- University of South Santa Catarina (UNISUL), Florianópolis, Santa Catarina Brazil
- University of South Santa Catarina (UNISUL), Av. José Acácio Moreira, 787, Tubarão, Santa Catarina Brazil
| | | | | | | | - Gina Carriero Lima
- University of South Santa Catarina (UNISUL), Av. José Acácio Moreira, 787, Tubarão, Santa Catarina Brazil
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23
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Yoon KC, Choi W, Lee HS, Kim SD, Kim SH, Kim CY, Park KH, Park YJ, Baek SH, Song SJ, Shin JP, Yang SW, Yu SY, Lee JS, Lim KH, Oh KW, Kang SW. An Overview of Ophthalmologic Survey Methodology in the 2008-2015 Korean National Health and Nutrition Examination Surveys. KOREAN JOURNAL OF OPHTHALMOLOGY 2015; 29:359-67. [PMID: 26635451 PMCID: PMC4668250 DOI: 10.3341/kjo.2015.29.6.359] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 10/19/2015] [Indexed: 01/01/2023] Open
Abstract
The Korea National Health and Nutrition Examination Survey (KNHANES) is a national program designed to assess the health and nutritional status of the noninstitutionalized population of South Korea. The KNHANES was initiated in 1998 and has been conducted annually since 2007. Starting in the latter half of 2008, ophthalmologic examinations were included in the survey in order to investigate the prevalence and risk factors of common eye diseases such as visual impairment, refractive errors, strabismus, blepharoptosis, cataract, pterygium, diabetic retinopathy, age-related macular degeneration, glaucoma, dry eye disease, and color vision deficiency. The measurements included in the ophthalmic questionnaire and examination methods were modified in the KNHANES IV, V, and VI. In this article, we provide detailed information about the methodology of the ophthalmic examinations in KNHANES in order to aid in further investigations related to major eye diseases in South Korea.
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Affiliation(s)
- Kyung Chul Yoon
- Department of Ophthalmology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Won Choi
- Department of Ophthalmology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Hyo Seok Lee
- Department of Ophthalmology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Sang-Duck Kim
- Department of Ophthalmology, Wonkwang University School of Medicine, Iksan, Korea
| | - Seung-Hyun Kim
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - Chan Yun Kim
- Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
| | - Ki Ho Park
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
| | | | - Seung-Hee Baek
- Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea
| | - Su Jeong Song
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Pil Shin
- Department of Ophthalmology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Suk-Woo Yang
- Department of Ophthalmology, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Seung-Young Yu
- Department of Ophthalmology, Kyung Hee University School of Medicine, Seoul, Korea
| | - Jong Soo Lee
- Department of Ophthalmology, Pusan National University College of Medicine, Busan, Korea
| | - Key Hwan Lim
- Department of Ophthalmology, Ewha Womans University School of Medicine, Seoul, Korea
| | - Kyung Won Oh
- Division of Health and Nutrition Survey, Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Se Woong Kang
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Fenwick EK, Xie J, Man REK, Lim LL, Flood VM, Finger RP, Wong TY, Lamoureux EL. Moderate consumption of white and fortified wine is associated with reduced odds of diabetic retinopathy. J Diabetes Complications 2015; 29:1009-14. [PMID: 26431588 DOI: 10.1016/j.jdiacomp.2015.09.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 09/01/2015] [Accepted: 09/01/2015] [Indexed: 01/26/2023]
Abstract
AIM To explore the association between alcohol consumption and the severity of diabetic retinopathy (DR). METHODS In this cross-sectional study, patients with type 2 diabetes answered questions on consumption of low and full-strength beer, white wine/champagne, red wine, fortified wines, and spirits. Never, moderate and high consumption of each alcoholic beverage, and overall alcoholic beverage consumption, were defined as <1, 1-14 and >14 standard drinks/week, respectively. DR was categorized into none; non vision-threatening DR (VTDR) and VTDR. Multivariable logistic regression determined the associations between alcohol consumption and DR. RESULTS Of the 395 participants (mean age±SD [standard deviation] 65.9±10.4years; males=253), 188 (47.6%) consumed alcohol and 235 (59.5%) had any DR. Compared to no alcohol consumption, moderate alcohol consumption (overall) was significantly associated with reduced odds of any DR (OR=0.47, 95% CI [confidence interval] 0.26-0.85). Moderate consumption of white wine/champagne or fortified wine was also associated with reduced odds of any DR (OR=0.48, 95% CI 0.25-0.91, and OR=0.15, 95% CI 0.04-0.62, respectively). Similar results were observed for non-VTDR and VTDR. CONCLUSIONS The amount and type of alcohol are associated with risk of DR in patients with type 2 diabetes. A longitudinal study is needed to assess the protective effect of alcohol consumption and DR.
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Affiliation(s)
- Eva K Fenwick
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Australia.
| | - Jing Xie
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Australia
| | - Ryan Eyn Kidd Man
- Singapore Eye Research Institute, National University of Singapore, Singapore
| | - Lyndell L Lim
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Australia
| | - Victoria M Flood
- Faculty of Health Sciences, University of Sydney, Australia and St Vincent's Hospital, Sydney, Australia
| | - Robert P Finger
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Australia
| | - Tien Y Wong
- Singapore Eye Research Institute, National University of Singapore, Singapore; Duke-National University of Singapore Graduate Medical School, Singapore
| | - Ecosse L Lamoureux
- Singapore Eye Research Institute, National University of Singapore, Singapore; Duke-National University of Singapore Graduate Medical School, Singapore
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25
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Nentwich MM, Ulbig MW. Diabetic retinopathy - ocular complications of diabetes mellitus. World J Diabetes 2015; 6:489-499. [PMID: 25897358 PMCID: PMC4398904 DOI: 10.4239/wjd.v6.i3.489] [Citation(s) in RCA: 274] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 01/03/2015] [Accepted: 01/20/2015] [Indexed: 02/05/2023] Open
Abstract
In industrialized nations diabetic retinopathy is the most frequent microvascular complication of diabetes mellitus and the most common cause of blindness in the working-age population. In the next 15 years, the number of patients suffering from diabetes mellitus is expected to increase significantly. By the year 2030, about 440 million people in the age-group 20-79 years are estimated to be suffering from diabetes mellitus worldwide (prevalence 7.7%), while in 2010 there were 285 million people with diabetes mellitus (prevalence 6.4%). This accounts for an increase in patients with diabetes in industrialized nations by 20% and in developing countries by 69% until the year 2030. Due to the expected rise in diabetic patients, the need for ophthalmic care of patients (i.e., exams and treatments) will also increase and represents a challenge for eye-care providers. Development of optimized screening programs, which respect available resources of the ophthalmic infrastructure, will become even more important. Main reasons for loss of vision in patients with diabetes mellitus are diabetic macular edema and proliferative diabetic retinopathy. Incidence or progression of these potentially blinding complications can be greatly reduced by adequate control of blood glucose and blood pressure levels. Additionally, regular ophthalmic exams are mandatory for detecting ocular complications and initiating treatments such as laser photocoagulation in case of clinical significant diabetic macular edema or early proliferative diabetic retinopathy. In this way, the risk of blindness can considerably be reduced. In advanced stages of diabetic retinopathy, pars-plana vitrectomy is performed to treat vitreous hemorrhage and tractional retinal detachment. In recent years, the advent of intravitreal medication has improved therapeutic options for patients with advanced diabetic macular edema.
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Hu Y, Teng W, Liu L, Chen K, Liu L, Hua R, Chen J, Zhou Y, Chen L. Prevalence and risk factors of diabetes and diabetic retinopathy in Liaoning province, China: a population-based cross-sectional study. PLoS One 2015; 10:e0121477. [PMID: 25785633 PMCID: PMC4364908 DOI: 10.1371/journal.pone.0121477] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Accepted: 02/11/2015] [Indexed: 11/25/2022] Open
Abstract
Aim To evaluate the prevalence and risk factors of diabetes and diabetic retinopathy (DR) in northeast area of China with a population-based study. Methods A population of 3173 (aged from 20 to 80 years old) was stratified by geographical location and age in Liaoning province, China. Prediabetes and diabetes were diagnosed according to the guideline of American Diabetes Association. Retinal photographs were obtained by using digital non-mydriatic camera for the presence and grading of DR according to the modified ETDRS Airlie house classification. Blood samples and comprehensive questionnaires were obtained for evaluation of laboratory results and risk factors. Results The prevalence of prediabetes and diabetes was 20.7% and 10.4%, respectively. Among diabetes patients, DR prevalence was 11.9%. Age, obesity, total cholesterol, triglycerides, hypertension, living in rural areas and diabetes family history are all risk factors for prediabetes and diabetes. Waist-to-hip circumference rate served as a better obesity index to estimate diabetes risk compared with body mass index and waist circumference. Among all risk factors that we investigated, only the length of diabetes history was associated with the incidence of DR. However, DR prevalence in the newly discovered patients in rural areas was significantly higher than that in urban areas. Conclusion According to this study, 1 in 10 people has diabetes, 2 in 10 people have prediabetes, and 1 in 10 diabetics has DR in Liaoning province. In rural areas, diabetes was poorly recognized with limited medical resources, which probably resulted in more diabetes patient at a high risk of DR.
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Affiliation(s)
- Yuedong Hu
- Department of Ophthalmology, the First Affiliated Hospital of China Medical University, Shenyang City, Liaoning Province, the People’s Republic of China
- Diabetic Eye Center of Liaoning province, Shenyang City, Liaoning Province, the People’s Republic of China
| | - Weiping Teng
- Department of Endocrinology, the First Affiliated Hospital of China Medical University, Shenyang City, Liaoning Province, the People’s Republic of China
- The key Laboratory of Endocrine diseases of Liaoning Province, Shenyang City, Liaoning Province, the People’s Republic of China
| | - Limin Liu
- Department of Ophthalmology, the First Affiliated Hospital of China Medical University, Shenyang City, Liaoning Province, the People’s Republic of China
- Diabetic Eye Center of Liaoning province, Shenyang City, Liaoning Province, the People’s Republic of China
| | - Kang Chen
- Department of Ophthalmology, the First Affiliated Hospital of China Medical University, Shenyang City, Liaoning Province, the People’s Republic of China
| | - Lei Liu
- Department of Ophthalmology, the First Affiliated Hospital of China Medical University, Shenyang City, Liaoning Province, the People’s Republic of China
- Diabetic Eye Center of Liaoning province, Shenyang City, Liaoning Province, the People’s Republic of China
| | - Rui Hua
- Department of Ophthalmology, the First Affiliated Hospital of China Medical University, Shenyang City, Liaoning Province, the People’s Republic of China
| | - Jun Chen
- Department of Ophthalmology, the First Affiliated Hospital of China Medical University, Shenyang City, Liaoning Province, the People’s Republic of China
| | - Yun Zhou
- Department of Ophthalmology, the First Affiliated Hospital of China Medical University, Shenyang City, Liaoning Province, the People’s Republic of China
| | - Lei Chen
- Department of Ophthalmology, the First Affiliated Hospital of China Medical University, Shenyang City, Liaoning Province, the People’s Republic of China
- Diabetic Eye Center of Liaoning province, Shenyang City, Liaoning Province, the People’s Republic of China
- The key Laboratory of Endocrine diseases of Liaoning Province, Shenyang City, Liaoning Province, the People’s Republic of China
- * E-mail:
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