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David Peprah, Christopher K Hwang, Elvira Agron, Anne E Sumner, Emily Y Chew; Diabetes and Diabetic Retinopathy in African-born Blacks Living in America: A Cross-sectional Study. Invest. Ophthalmol. Vis. Sci. 2021;62(8):1105.
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Working with African-born Blacks living in America, the aims were to: (1) determine the prevalence and risk factors associated with diabetic retinopathy (DR) (2) evaluate for other ocular abnormalities
This was a cross-section evaluation of 265 African-born blacks living in the United States (male 62%, age 39.7±10.2y (mean±SD), BMI 27.8±4.5 kg/m2) who self-identified as healthy. Participants had oral glucose tolerance test (OGTT) to determine glucose tolerance status, comprehensive eye exams, spectral domain optical coherence tomography (OCT) and fundus photos. In addition, A1C, glycated albumin (GA) and fructosamine levels were determined, allostatic load score (ALS) as a measure of physiologic stress was calculated and visceral adiposity was assessed with abdominal CT scan.
Newly diagnosed diabetes mellitus (DM) occurred in 10.2% (27/265), preDM in 40.0% (106/265), normal glucose tolerance (NGT) in 49.1% (130/265). Retinopathy was present in 1.5% (4/265) overall, 18.5% (3/27) in those with DM, 1.0% (1/104) with preDM, and 2.3% (3/130) with NGT. The 3 NGT cases with retinopathy had hypertension and were excluded from analysis. Among diagnostic testing modalities, on univariate analyses, statistical significant associations with DR were found in fasting plasma glucose (P<0.002), 2h glucose from the OGTT (P=0.010), and fructosamine (P=0.025) but no associations were found with A1C or GA (P=0.089, P=0.142, respectively); and higher visceral adipose tissue and allostatic load score were associated with DR (P=0.049 and P=0.025, respectively). The number of participants affected with DR is too low for meaningful analyses with multivariate regression. Additional ocular features evaluated showed 34.7% of all participants had 0.5 or greater cup/disc ratio while the mean intraocular pressure was 15 ± 3 mmHg. The mean visual acuity was 20/25 for those without retinopathy and 20/36 for those with retinopathy (P=0.037). The retinal thickness measured by OCT demonstrated no differences in the inner retinal thickness when comparing glycemic status.
In conclusion, the overall combined prevalence of DM and preDM was high (50.2%) in this population, DR was present in 18.5% with DM. There is relatively high proportion of the participants with large cup/disc ratios. Multivariate regression was not performed. These findings warrant further exploration in this population.
This is a 2021 ARVO Annual Meeting abstract.
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