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S. Kaushik, J.J. Wang, A. Kifley, P. Mitchell, Blue Mountains Eye Study; Factors Associated With Prevalence of Retinopathy in Persons Without Diabetes: The Blue Mountains Eye Study . Invest. Ophthalmol. Vis. Sci. 2005;46(13):3276.
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Purpose: We previously reported a strong association between prevalence of retinopathy and hypertension in an older population–based sample without diabetes. This report aims to examine cross–sectional associations between retinopathy and other systemic factors in the same population. Methods: The baseline Blue Mountains Eye Study examined 3654 participants aged over 49+ years (82.4% of eligible) during during 1992–4. Retinopathy lesions (microaneurysms, hemorrhages, hard and soft exudates or intra retinal microvascular abnormalities) were assessed from masked grading of stereoscopic retinal photographs in persons without diabetes, defined from history and fasting glucose tests. Blood hemoglobin, lipids, glucose, creatinine and fibrinogen, body mass index (BMI), smoking and alcohol status were assessed for the association with retinopathy lesions, after controlling for age and blood pressure, using logistic regression models. Obesity was defined if BMI>30. Results: After excluding 276 persons with diabetes and 71 persons without photographs, 3307 of the 3654 participants were included in this study. The prevalence of any retinopathy lesion was 11.4% (95% CI 10.4–12.5, n=377), and was strongly age– (p for trend <.0001) and BP–related (p<.0001 for systolic and diastolic BP). After adjusting for age, no gender association was found (OR 1.04 95% CI 1.03–1.1). Borderline significant trends were found between increasing triglyceride level (OR 1.4 comparing the highest to lowest third, CI 1.0–1.8, p for trend 0.04) and fibrinogen level (OR 1.5 comparing highest to lowest third, CI 1.1–1.9, p for trend 0.02). Increasing creatinine (OR 1.006 for each µmol/L, CI 1.001–1.011) and decreasing HDL cholesterol level (OR 0.7 for each mmol/L, CI 0.5–0.9) were also associated with retinopathy, as was presence of obesity (OR 1.5, CI 1.1–2.0). However, after further adjusting for BP, only HDL cholesterol (OR 0.69 95% CI 0.51–0.92) and BMI were found significantly associated with retinopathy (p<.011 and <.005 for the quadratic terms). Conclusions: In this population without diabetes, other than increasing age and BP, we found that reduced HDL cholesterol level and higher BMI were associated with an increased likelihood of having retinopathy lesions.
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