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S. Song, M. Kim, J. Wang; Prevalence and Associations of Diabetic Retinopathy in Koreans. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3732.
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To evaluate prevalence and its associations of diabetic retinopathy (DR) in Korean patients with diabetes.
Consecutive 2033 patients with diabetes took ophthalmic exams at the ophthalmology department in the Diabetes Mellitus Center of Kangbuk Samsung Hospital, Korea, during May, 2007 to May, 2008. Retinal exams were performed after pupil dilation, and trained ophthalmologists in the ophthalmology department examined the retina of both eyes. Retinopathy severity was categorized based on the Early Treatment Diabetic Retinopathy Study grading protocol. Risk factors of diabetic retinopathy assessed included diabetic duration, treatment modality, presence of hypertension and microalbuminuria, fasting blood glucose and HbA1c levels, brachial-ankle pulse wave velocity (BaPWV), intima-media thickness (IMT) of common carotid artery and retinal vascular caliber.Odds ratio (OR) and 95% confident intervals (CI) were estimated after adjusting for these risk factors.
Of 2033 patients with diabetes, retinopathy was detected in 331 (16.3 %), with 146 (7.2 %) had mild non-proliferative diabetic retinopathy (NPDR), 78 (3.8 %) had moderate NPDR, 60 (2.9 %) showed severe NPDR and 47 (2.3%) proliferative diabetic retinopathy (PDR). After adjusting for age, gender, blood pressure, duration of diabetes, HbA1C, serum total cholesterol and triglycerides simultaneously in a logistic regression model, duration of diabetes (per 5 years, OR 2.25, CI 1.95-2.58), systolic blood pressure (per 10 mmHg increase, OR 1.43, CI 1.21-1.69), HbA1C (per 1% increase, OR 1.33, CI 1.21-1.47) were significantly associated with prevalence of DR. After adjusting for these factors, we found that BaPWV was independently associated with presence of DR (per 10% increase, OR 1.19, CI 1.07-1.31). In addition, there were significant associations of PDR with retinal vessel caliber (per 10 um reduction in mean arteriolar caliber, OR 2.14 CI 1.40-3.26 and per 10 um reduction in mean venular caliber, OR 2.09, CI 1.48-2.96) after adjusting for age, gender, blood pressure, duration of diabetes, HbA1C, serum cholesterol, triglycerides and previous panretinal photocoagulation.
: In addition to traditional DR risk factors, we found that systemic arterinal stiffness (BaPWV) was associated with higher prevalence of DR in our sample of Korean patients with diabetes, indicating functional alteration in microcirculation system in patients with DR, a major microvascular complication of diabetes.
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