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Mohamed Dirani, Jing Xie, Eva Fenwick, Rehab Benarous, Gwyneth Rees, Tien Wong, Ecosse L. Lamoureux; Body Mass Index, Anthropometric Parameters and Diabetic Retinopathy: The Diabetes Management Project (DMP). Invest. Ophthalmol. Vis. Sci. 2011;52(14):596.
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To examine the association between body mass index (BMI), stature, anthropometric parameters, and diabetic retinopathy (DR) in a large clinical sample of adults with type I and II diabetes.
Study patients were recruited from specialised eye clinics in Melbourne (Australia) at baseline. Each underwent a comprehensive eye examination, anthropometric measurements, standardised interview-administered questionnaires and a collection of urine, fasting blood glucose and serum lipids. Two-field dilated fundus photographs were captured using a non-mydriatic fundus camera. Height, weight, body mass index (BMI), waist, hip, neck and head circumference, and skinfold measurement at one body site (right tricep) were recorded.
492 patients (325 males, 66.1%) aged between 26 and 90 years (median = 65.0 years) were included in this analysis. A total of 171 (34.8%), 187 (38.0%) and 134 (27.2%) had no DR, non-proliferative DR (NPDR) and proliferative DR (PDR), respectively, with missing data accounting for 8 cases (1.6%). After adjusting for sociodemographic and clinical characteristics, medical risk factors and bio-chemical parameters, higher BMI (OR [odds ratio] = 1.04, 95% CI [confidence interval] = 1.00, 1.08, p = 0.04) was significantly associated with any DR compared with normal BMI. Obese people were 2.3 times more likely to have DR (OR = 2.34, 95% CI = 1.20, 4.60, p = 0.013). Neck circumference (OR = 1.05, 95%CI = 1.00, 1.10, p = 0.03) was also significantly associated with any DR after multiple adjustments. BMI (OR = 1.04, 95%CI = 1.00, 1.08, p = 0.04) and neck circumference (OR = 1.05, 95% CI = 1.00, 1.09, p = 0.03) were also positively associated with increasing severity levels of DR.
Persons with diabetes with higher BMI and larger neck circumference are at greater risk of having any DR and more severe stages of DR. These data indicate that obesity is an independent risk factor for DR.
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