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Lucas J. Wendel, John J. Chen, Emily S. Birkholz, John G. Vallone, Michael D. Abramoff, Vinit B. Mahajan; Prevalence of the Metabolic Syndrome in Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2011;52(14):1264.
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To determine the prevalence of metabolic syndrome in diabetic retinopathy.
A retrospective chart review was completed of patients seen at the University of Iowa. 100 patients with proliferative diabetic retinopathy (PDR) requiring pars plana vitrectomy for either nonclearing vitreous hemorrhage or tractional retinal detachment between 2007 and 2010 were selected. Another 100 patients, with nonproliferative diabetic retinopathy (NPDR) during the same time period, were also randomly selected.The presence or absence of the metabolic syndrome (MS) was determined using the 2006 International Diabetes Foundation (IDF) definition. This definition requires central obesity, defined as a waist circumference >94cm for males and >80 cm for females be present. A BMI > 30 kg/m2 may be used as a surrogate for waist circumference. Two of the following criteria must also be met: serum triglycerides > 150mg/dl or specific treatment for this abnormality, serum HDL-cholesterol 85 mmHg or treatment for previously diagnosed hypertension. The final criteria is a fasting plasma glucose > 100 mg/dl or previously diagnosed type 2 diabetes.
The overall prevalence of metabolic syndrome was 66% (132 out of 200). There was no significant difference in the prevalence of MS between the PDR and NPDR groups, with rates of 64% and 61%, respectively. The average BMI was 33.6 + 7.7 kg/m2. 69.5% (139 our of 200) of the patients had a BMI >30 kg/m2. The NPDR cohort’s average BMI was 34.8 + 7.9 kg/m2, which was significantly higher than the average BMI of the PDR group, 32.4 + 6.65 kg/m2 (p<0.05). Overall, 92.5% of patients met the IDF criteria for hypertension, and 73.5% met the criteria for hyperlipidemia. There was no difference with regards to the hypertensive criteria, but NPDR patients were significantly more likely to meet criteria for hyperlipidemia (p<0.05).
There is a high prevalence of the metabolic syndrome in patients with diabetic retinopathy. There was no difference in the prevalence of the metabolic syndrome between patients with severe proliferative retinopathy and those with less severe, nonproliferative retinopathy. It is interesting that the NPDR control group had higher BMI’s and were more likely to meet the criteria for hyperlipidemia.
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