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Sunita Mohan, Uthra Satagopan, Manish Sonawane, Radhika Srinivasan, Sundaram Natarajan, Govindasamy Kumaramanickavel, Catherine A McCarty, Aditya Jyot Diabetic Retinopathy in Urban Mumbai Slums Study; Normal BMI also prone for Diabetic Retinopathy in Slums of Mumbai, Western India.. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5343.
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To investigate the association between obesity and diabetic retinopathy (DR) in subjects with Type 2 diabetes Mellitus (T2DM) in urban slums of Mumbai, India.
Four hundred and seventy subjects with T2DM were recruited from Aditya Jyot Diabetic Retinopathy in Urban Mumbai Slums Study, an on-going population based cross-sectional study in the urban slums of Mumbai. Each subject underwent anthropometric measurements and fundus photography using 30 degrees seven field stereoscopic digital photography. The diagnosis of DR was based on the modified Klein classification. Generalized obesity (BMI values) and abdominal obesity (waist circumference) were defined using WHO Asia Pacific guidelines with the BMI (body mass index) cut-off as > or =25 kg/m2, WC (waist circumference) cut-offs as >90 cm in men and > 80 cm in women. Comparison of the anthropometric parameters was done using Chi-square and Fisher Exact analyses, t-tests were used for continuous variables, using web-based statistical tools.
A total of 470 subjects (215 males, 45.7%) with T2DM were included in the analysis. The prevalence of DR among the diabetic population was 16.8% (n=78). No significant association (p>0.05) between any stage of DR and obesity (central obesity - waist circumference and generalized obesity- abdominal) was observed in the study groups except for subjects with DR under the normal weight category suggesting an association with the presence of DR that was statistically significant (p=0.03, one tailed). Also, though higher percentage of normal weight males and overweight females were found to have no signs of DR that was statistically significant (p=0.0005), this trend was not observed when the analysis was done with subjects who had T2DM for more than 10 years.
In the urban slums of western India, T2DM subjects with normal BMI are also prone to developing DR as compared to T2DM subjects with obesity. This is a significant finding in terms of understanding the etio - pathogenesis of DM and DR in this subset of population and needs to be explored further.
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