Prevalence of and risk factors for diabetic retinopathy in Koreans with type II diabetes: baseline characteristics of Seoul Metropolitan City-Diabetes Prevention Program (SMC-DPP) participants
- Cheol-Young Park1,
- Se Eun Park1,
- Ji Cheol Bae1,
- Won Jun Kim1,
- Sung Woo Park1,
- Man Mook Ha2,
- Su Jeong Song2
- 1Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Republic of Korea
- 2Department of Ophthalmology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Republic of Korea
- Correspondence to Su Jeong Song, 108 Pyeong-Dong, Jongno-Gu, Department of Ophthalmology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul 110-746, Republic of Korea;
- Accepted 27 June 2011
- Published Online First 20 July 2011
Objective To evaluate the prevalence of and risk factors for diabetic retinopathy (DR) in Koreans with type II diabetes.
Methods Subjects (400 male, 296 female) aged 30–65 years (mean 55.3 years) with hyperglycaemia (fasting plasma glucose ≥7.0 mmol/ml) or known diabetes (mean±SD duration 6.36±5.73 years) were enrolled in the Seoul Metro-City Diabetes Prevention Program (SMC-DPP) from September 2008 to September 2009. The severity of DR was diagnosed by grading fundus photographs taken from five standard fields per eye and categorised following the Early Treatment of Diabetic Retinopathy Study grading protocol. All participants underwent routine clinical and laboratory examinations to evaluate risk factors for DR.
Results The overall prevalence of any type of DR was 18.7%. Logistic regression analyses showed that the following factors were significantly associated with DR after adjustment for age and gender, duration of diabetes, serum glycated haemoglobin A1c (HbA1c), mean arterial pressure, serum total cholesterol and serum triglycerides: duration of diabetes (OR 1.14, 95% CI 1.10 to 1.18, for 1 year increase), HbA1c (OR 1.49, 95% CI 1.20 to 1.85, for 1% increase), serum concentration of insulin (OR 0.87, 95% CI 0.81 to 0.94, for 1 μIU/ml increase), homoeostasis model assessment of insulin resistance (OR 0.06, 95% CI 0.01 to 0.29, for 10 unit increase), and presence of macroalbuminuria (OR 5.14, 95% CI 1.45 to 18.20, albumin to creatinine ratio >300 mg/g).
Conclusions In addition to traditional risk factors, insulin resistance was associated with an increased risk of DR in Koreans with type 2 diabetes.
Funding Seoul government and ministry of health in Korea.
Competing interests None.
Patient consent Obtained.
Ethics approval This study was conducted with the approval of the Kangbuk Samsung Hospital institutional review board.
Provenance and peer review Not commissioned; externally peer reviewed.