Abstract
Purpose :
Diabetic retinopathy (DR) remains a leading cause of visual impairment and blindness worldwide, despite advances in treatment. Identifying potential risk factors for progression of DR may help reduce the burden of DR-related vision loss. We examined the association between DR progression and dietary fat intake assessed in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study.
Methods :
ACCORD (1999-2012) was a clinical trial evaluating the efficacy of strict blood glucose, blood pressure control, and management of dyslipidemia on cardiovascular disease (CVD). At annual visits, participants reported whether they had undergone treatment vitrectomy (VTX) or laser photocoagulation (PC) for DR. A subset of participants had color stereoscopic fundus photographs that were graded for presence and severity of DR. In a subset of ACCORD participants, the Puget Sound Eating Patterns (PEP) questionnaire was used to assess dietary fat intake at baseline: five subscales and one summary scale (range 1-4, 4 indicating highest fat intake) were computed to describe behavioral factors related to decreased fat intake. Progression of DR at the 4-year study visit (ProgDR4yr) was defined as either a >=3-step worsening on the ETDRS scale in either eye or a report of VTX/PC in either eye by the 4-year study visit. Participants with proliferative DR or VTX/PC at baseline study visit were excluded.
Results :
A total of 1757 ACCORD participants (mean age, 62.6 years (range 44-79), 39% female, 35% non-white; 13% current smokers; duration of diabetes 0-35 years (mean 10.4); Hgb A1c 5.8-13.5% (mean 8.3); high-density lipoprotein 15-107 mg/dL (mean 41.9); albumin:creatinine ratio 2.0-5453 mg/g (mean 97.7); 35% with history of CVD at baseline) had dietary data. 120 patients (6.8%) had ProgDR4. Factors associated with ProgDR4yr in univariable analyses included duration, HgbA1c, HDL, and albumin:creatinine ratio. In the multivariable analyses, none of the PEP subscales or summary scale were associated with ProgDR4yr (Table 1).
Conclusions :
We found no evidence of association of dietary fat intake with ProgDR4yr in ACCORD participants. Further research is needed to assess a broader range of dietary factors with risk of DR.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.