High Prevalence of Diabetic Retinopathy in Diabetic Patients Concomitant with Metabolic Syndrome

• Published in: PloS one Vol. 11; no. 1; p. e0145293
• Main Authors: Gao, Lu, Xin, Zhong, Yuan, Ming-Xia, Cao, Xi, Feng, Jian-Ping, Shi, Jing, Zhu, Xiao-Rong, Yang, Jin-Kui
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 08.01.2016; Public Library of Science (PLoS)
• Subjects: Adolescent; Adult; Aged; Blood Pressure; Body mass index; Cardiovascular disease; Case-Control Studies; Cholesterol; Cholesterol - blood; Complications; Complications and side effects; Demographic aspects; Demography; Diabetes; Diabetes mellitus; Diabetes Mellitus, Type 2 - pathology; Diabetic retinopathy; Diabetic Retinopathy - complications; Diabetic Retinopathy - diagnosis; Diabetic Retinopathy - epidemiology; Diagnostic systems; Digital imaging; Disease prevention; Endocrinology; Family medical history; Fasting; Female; Glucose; Glycated Hemoglobin A - analysis; Health risk assessment; Heart; Hemoglobin; Hospitals; Humans; Hyperglycemia; Hypertension; Laboratories; Laboratory tests; Logistic Models; Lungs; Male; Metabolic syndrome; Metabolic Syndrome - complications; Metabolic Syndrome - diagnosis; Metabolic syndrome X; Microvasculature; Middle Aged; Obesity; Odds Ratio; Patients; Population; Population (statistical); Prevalence; Prevalence studies (Epidemiology); Prognosis; Research design; Retina; Retinal images; Retinopathy; Risk analysis; Risk Factors; Sex ratio; Statistics; Studies; Waist Circumference; Young Adult; China; Beijing China
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0145293

To evaluate the relationship between metabolic syndrome (MetS) and the prevalence of diabetic retinopathy (DR). We conducted a case-controlled study, with data obtained from 2,551 Chinese participants between 18-79 years of age (representing a population of 1,660,500 in a district of Beijing). 74 cases of DR were found following data assessment by two 45° digital retinal images. Subjects without DR (NDR group) selected from the remaining 2,477 subjects were matched 1:1 to the DR group by HbA1c. MetS was defined by incorporating diagnostic criteria of the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) and the International Diabetes Federation (IDF). There were no statistical differences between the DR group and NDR group in a number of biological or laboratory tests. However, the percentage of patients with DR increased vs. patients without DR with the number of MetS components from 1 to 5 (14.3% vs. 85.7%, 38.9% vs. 61.1%, 49.1% vs. 50.9%, 61.4% vs. 38.6% and 83.3% vs. 16.7%, respectively) (Pearson χ2 = 9.938, P = 0.037). The trend to develop DR with MetS was significantly higher than that without MetS (NMetS) (χ2 = 5.540, P = 0.019). MetS was an independent statistical indicator of the presence of DR after adjusting for age and sex [odds ratio (95% CI): 2.701(1.248-5.849), P = 0.012], which is still the case with an additional adjustment for WC, SBP, TC, HbA1c and duration of diabetes [odds ratio (95% CI): 2.948(1.134-7.664), P = 0.027]. DR is one of the diabetic microvascular complications. Apart from poor glycemic control, the concomitance of other metabolic factors can also influence DR. MetS, defined as a cluster of metabolic risk factors, is a strong and independent indicator of DR, even to the same extent as glycemic control.