Diabetic Retinopathy in Japanese–Brazilian Population: Prevalence and Associated Factors

Abstract

Abstract: : Purpose: To determine the prevalence and associated factors of diabetic retinopathy in Japanese–Brazilian population living in the city of Bauru, State of São Paulo, Brazil. Methods: Brazil has the largest Japanese community living outside Japan. In 1997, 435 families from this community were visited and submmited to home interview about their social, demographic, and health conditions. The total Japanese community from Bauru was 3,574 people; 1,751 were over 30 years old (405 from the first generation – issei – and 1,346 from the second generation – nissei). During 1 year, all the people over 30 years old was invited to participate in clinical and laboratorial examinations including fasting glucose test and 75g oral glucose tolerance test .1,330 subjects were submitted to exams and 482 presented type 2 diabetes mellitus (DM2) according to WHO criteria–1999. Complete ophthalmic examination was perfomed in 382 subjects (mean age 59.6±11.0 years).Results: The prevalence of diabetes in Japanese–Brazilian population was 36.2%(95% CI: 33.6–38.8%) The prevalence of retinopathy(PR) was 8.4% (95% CI:5.6%–11.2%) and the duration of DM2 was 8.46±1.44 years higher in patients with retinopathy than patients without retinopathy(p<0.001). Factors associated with retinopathy were duration of diabetes (10.75±7.49 years), a high fasting and 2h plasma glucose, glycosylated hemoglobin, systolic blood pressure and uric acid (p<0.001) . No association were observed regarding total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, creatinine,BMI and waist–to–rip ratio(p>0.001). Homocysteinemia was higher in diabetic patients without retinopathy (p<0.01).Conclusions: The Japanese–Brazilian population has a high prevelence of type 2 diabetes and a low prevalence of retinopathy but adequate glycemic control is necessary to minimize the progression of diabetic retinopathy. Presence of other factors associated to retinopathy suggest that efforts to control diabetes should be important to reduce complications related to DM2.

Keywords: diabetic retinopathy • diabetes • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials