Elevated Body Mass Index is Associated With Higher Prevalence of Macular Edema in Patients With Type 2 Diabetes

Abstract

Purpose: : Our aim was to look at elevated body mass index (BMI) as an independent risk factor in the development of diabetic macular edema (DME) in patients with type 2 diabetes.

Methods: : This project consists of a Cross sectional epidemiological study surveying patients visiting the Diabetes Clinic at the American University of Beirut Medical Center. A complete medical evaluation was followed by a comprehensive ophthalmologic examination and digital stereo fundus photography . Using the CDC classification the patients were divided according to their BMI value namely underweight, normal, overweight and obese. The prevalence of macular edema was calculated in each group. Comparison between the prevalence of DME in different groups was obtained using the chi–square test.

Results: : Of the 310 patients with type 2 diabetes that were examined, 55% were females with an age range between 28 and 90 years (mean 61 years). Mean known duration of disease was 8 years (range 3 months to 44 years), and mean value for HbA1 C level was 8.5% with a range from 5 to 14.5%. BMI measurement revealed values ranging from 17.8 to 48 (mean 27). None of the patients with a low BMI (underweight) had macular edema, while patients with normal BMI value had a 5% prevalence. Overweight or obese patients had a 9.05% prevalence of macular edema. Differences in the values among all the groups were statistically significant (P<0.0001). Multivariate analysis was done correcting for HbA1C, duration of disease, level of retinopathy, systolic and diastolic blood pressure measurements revealed that BMI continues to affect macular edema independently of other parameters (P<0.01).

Conclusions: : Elevated BMI values may be another risk factor in the development of DME.

Keywords: clinical (human) or epidemiologic studies: prevalence/incidence • diabetic retinopathy • macula/fovea