Factors Associaed with Diabetic Retinopathy in Type 2 Diabetes

Abstract

Factors Associaed with Diabetic Retinopathy in Type 2 Diabetes

Supatra             Chaikaew                             BNS, MSc (Public Health)*

Natchaporn      Pichainarong                      DrPH (Epidemiology)**

Wisit                  Chaveepojnkamjorn         DVM, MPH**

Piangchan        Rojanavipart                       MHS (Biostatistics)***

Petch                 Rawdaree                            MD,MSc (Epidemiology)****

* Amnatchareon Hospital

** Department of Epidemiology, Faculty of Public Health, Mahidol University

*** Department of Biostatistic, Biostatic, Faculty of Public Health, Mahidol University

**** Department of Medicine, BMA Medical college and Vajira HospItal

Objective: To determine factors associated with diabetic retinopathy in type 2 diabetes.

Study design: Hospital based case-control study.

Setting: Diabetes Clinic, BMA Medical college and Vajira Hospital from May 2003 to September 2003.

Subjects: Two hundred and sixty type 2 diabetes mellitus. One hundred and thirty patients with diabetic retinopathy were     case and 130 patients without diabetic retinopathy were control.

Methods: Data were collected from medical record and interview questionnaire. It is divided into 3 sections: Information from interview; part 1 general information including demography and socio-economy, part 2 illness factors, part 3 laboratory data which was obtained from medical record. The obtained data were analyzed by statistical program.

Main outcome measures: Odds ratio and 95% CI of odds ratio of hyperglycemia, hypertension, type of therapy, smoking, (Body mass index : BMI), age at onset, alcohol consumption, dyslipidemia and duration of diabetes.

Results: There were only five variable that were significantly associated with diabetic retinopathy. After adjusting the effect of each variables, the magnitude of association between each variables and diabetic retinopathy were fasting plasma glucose (FPG) between 161-180 mg/dl and >180 mg/dl (OR=3.82, 95% CI 1.02-14.24 and OR=5.98, 95% CI 1.66-21.56), HbA1c >9%(OR=4.09, 95% CI 1.69-9.92), hypertension (OR=5.00, 95% CI 2.64-9.46), systolic blood pressure between 140-159 mmHg and 160 mmHg (OR=3.22, 95% CI 1.50-6.88 and OR=9.98, 95% CI 1.38-58.41) and BMI between 23-24.9, 25-29 and 30 kg/m (OR=0.20, 95% CI 0.08-0.49, OR=0.36, 95% CI 0.16-0.83 and OR=0.10, 95% CI 0.03-0.32) respectively. Other variables consisted of diastolic blood pressure, cholesterol, triglyceride, type of therapy, age at onset duration of diabetes, smoking and alcohol consumption did not show significant association with diabetic retinopathy.

Conclusion: The factors found to be significantly associated with diabetic retinopathy were FPG, HbA1c, BMI, hypertension and systolic blood pressure.

Key words: Type 2 diabetes, diabetic retinopathy, risk factors

Vajira Med J 2004 ; 48 : 97 - 106