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Geir Bertelsen, Maja G. Erke, Anne K. Sjolie, Inger Njoelstad; Sex difference in risk factors for retinopathy in an older population without diabetes: The Tromsø Eye Study. Invest. Ophthalmol. Vis. Sci. 2012;53(14):986.
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To assess risk factors for retinopathy by sex in non-diabetic participants in the Tromsø Eye Study population.
We analysed data from the population-based, cross-sectional Tromsø Eye Study conducted in 2007-8 in the municipality of Tromsø, Norway. Retinal photographs of 6540 Caucasian participants aged 38-87 years were graded for retinopathy according to The International Clinical Diabetic Retinopathy and Diabetic Macular Edema Disease Severity Scales. Risk factor exposure was collected from questionnaires and physical examination. Participants with missing exposure variables, retinal vessel occlusions, HbA1c > 6.5 %, non-fasting glucose ≥ 11.1 mmol/l, self-reported diabetes or use of anti-diabetic medication were excluded from the analyses. Microalbuminuria was defined according to sex specific cut-off values for albumin-creatinine ratio (1.92 mg/mmol in men and 2.83 mg/mmol in women). Logistic regression was used to assess associations between retinopathy and risk factors.
The analyses included 3169 women and 2367 men with complete datasets. A total of 410 women and 351 men had retinopathy. Age was significantly associated (p<0.05) with retinopathy in women and men. Adjusted for age, retinopathy was significantly associated with systolic blood pressure (OR 1.01, 95% CI 1.00-1.01), total cholesterol (OR 1.12, 95% CI 1.01-1.24) and microalbuminuria (OR 2.20, 95% CI 1.40-3.45) in women, and with HbA1c (OR 1.47, 95% CI 1.06-2.03) in men. In a multivariable model that included age, systolic blood pressure, total cholesterol, microalbuminuria and smoking, retinopathy was associated with age (OR 1.03, 95% CI 1.02-1.04), systolic blood pressure (OR 1.01, 95% CI 1.00-1.01), total cholesterol (OR 1.12, 95% CI 1.01-1.24) and microalbuminuria (OR 2.14, 95%CI 1.35-3.38) in women. In men, the only significant association was HbA1c (OR 1.47, 95% CI 1.05-2.05).
We observed sex differences in risk factors for retinopathy in the present population-based cross sectional study of elderly without diabetes. In the multivariable model, age, systolic blood pressure, microalbuminuria and total cholesterol were associated with retinopathy in women. In men retinopathy was associated with HbA1c.
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