June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
The Relationship of Dietary Fish Intake and Diabetic Retinopathy in Asian Patients with Type 2 Diabetes
Author Affiliations & Notes
  • Jacqueline Chua
    Ocular Imaging, Singapore Eye Research Institute, Singapore, Singapore, Singapore
    Duke-National University of Singapore Medical School, Singapore, Singapore, Singapore
  • Airu Chia
    Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
  • Mary Foong-Fong Chong
    Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
  • Ryan Man
    Singapore Eye Research Institute, Singapore, Singapore
  • Gavin S Tan
    Singapore Eye Research Institute, Singapore, Singapore
  • Ecosse Luc Lamoureux
    Singapore Eye Research Institute, Singapore, Singapore
  • Tien Yin Wong
    Singapore Eye Research Institute, Singapore, Singapore
  • Leopold Schmetterer
    Singapore Eye Research Institute, Singapore, Singapore
  • Footnotes
    Commercial Relationships   Jacqueline Chua, None; Airu Chia, None; Mary Foong-Fong Chong, None; Ryan Man, None; Gavin Tan, None; Ecosse Lamoureux, None; Tien Wong, None; Leopold Schmetterer, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 4284. doi:
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      Jacqueline Chua, Airu Chia, Mary Foong-Fong Chong, Ryan Man, Gavin S Tan, Ecosse Luc Lamoureux, Tien Yin Wong, Leopold Schmetterer; The Relationship of Dietary Fish Intake and Diabetic Retinopathy in Asian Patients with Type 2 Diabetes. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4284.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : Recent studies have shown favorable associations between fish consumption and sight threatening diabetic retinopathy (DR) in Western populations. We tested the hypothesis that individuals with higher fish intake will have less severe stage of diabetic retinopathy (DR) in a clinical sample of Asian patients with type 2 diabetes

Methods : This is a clinical cross-sectional study of 389 Asian adults with diabetes. Fish consumption was evaluated using the Singapore-validated food frequency questionnaires, which included frequency estimates of fish intake. DR severity was assessed from two-field fundus images and based on the modified Airlie House Classification: none (n = 156), minimal (Early Treatment Diabetic Retinopathy Study [ETDRS] scale score, 20; n = 28), mild-moderate (ETDRS scale score, 35-47; n = 126), and severe DR (ETDRS scale score, >53; n = 79). Multivariable multinomial logistic model was used to investigate the association of fish intake with DR severity, adjusting for age, sex, race, body mass index, years after diagnosis of diabetes, smoking, systolic blood pressure, total to HDL cholesterol ratio, and HbA1c.

Results : Among the participants (mean [SD] age, 56.9 [7.4] years; 30.9% women; 76.9% Chinese), the median (interquartile range) for fish intake was 3.0 (3.0) times per week. In the adjusted models, dietary fish intake was inversely associated with severe DR (odds ratio [OR], 0.26; 95% confidence interval (CI): 0.10 to 0.68; P = 0.006), comparing highest vs lowest quartile of intake, and a significant trend for increasing frequency of fish consumption (OR = 0.81, 95% CI: 0.71 to 0.93 per 1-unit increase; P = 0.002). No statistically significant relationships existed for the minimal or mild-moderate DR groups.

Conclusions : Higher intake of fish was associated with a decreased likelihood of having severe DR in Asian adults with type 2 diabetes. Our results concur with findings from Western population that fish consumption may protect against severe forms of DR.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.


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