Prevalence and Risk Factors for Diabetic Retinopathy The Singapore Malay Eye Study

Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia.
Ophthalmology (Impact Factor: 6.14). 07/2008; 115(11):1869-75. DOI: 10.1016/j.ophtha.2008.05.014
Source: PubMed


To describe the prevalence and risk factors of diabetic retinopathy in Asian Malays.
Population-based cross-sectional study.
Persons with diabetes of Malay ethnicity aged 40 to 80 years in Singapore.
Diabetes mellitus was defined as random glucose of 11.1 mmol/l or more, use of diabetic medication, or a physician diagnosis of diabetes. Retinal photographs taken from both eyes were graded for diabetic retinopathy using the modified Airlie House classification system.
Any diabetic retinopathy, retinopathy grades, macular edema, or vision-threatening retinopathy.
Of the 3261 persons who participated in this study, 757 (23.1%) had diabetes and gradable retinal photographs. In persons with diabetes, the overall prevalence of any retinopathy was 35.0% (95% confidence interval [CI], 28.2-43.4), the overall prevalence of macular edema was 5.7% (95% CI, 3.2-9.9), and the overall prevalence of vision-threatening retinopathy was 9.0% (95% CI, 5.8-13.8). Compared with men, women had significantly higher proportions with more severe diabetic retinopathy, moderate (12% vs. 4%) and severe (3% vs. 0.2%) nonproliferative retinopathy, proliferative retinopathy (7% vs. 2%), and vision-threatening retinopathy (13% vs. 3%). In multiple logistic regression, independent risk factors for any retinopathy were longer diabetes duration (odds ratio [OR], 1.07; 95% CI, 1.04-1.09, per year increase), higher hemoglobin A1(c) (OR, 1.21; 95% CI, 1.10-1.33, per % increase), hypertension (OR, 1.85; 95% CI, 1.04-3.30), and higher pulse pressure (OR, 1.34, 95% CI, 1.19-1.51, per 10-mmHg increase); older age (OR, 0.73; 95% CI, 0.57-0.93, per decade increase) and higher total cholesterol levels (OR, 0.75; 95% CI, 0.63-0.89, per 1-mmol/l increase) were protective of any retinopathy. Vision-threatening retinopathy additionally was associated with previous stroke (OR, 3.74; 95% CI, 1.24-11.26), cardiovascular disease (OR, 2.23; 95% CI, 1.08-4.62), and chronic kidney disease (OR, 4.45; 95% CI, 2.18-9.07). Female gender was not an independent risk factor for diabetic retinopathy after adjusting for metabolic and socioeconomic risk factors.
One in 10 Malay adults with diabetes in Singapore has vision-threatening diabetic retinopathy. Risk factors for retinopathy in this population are largely similar to white populations elsewhere, suggesting that control of these risk factors may reduce both the prevalence and impact of retinopathy.

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    • "Studies have shown that HbA1c was a pivotal risk factor for DR in patients with diabetes [5,22,28-32]. Consistent with previous studies, the present study showed HbA1c was an important risk factor for DR in subjects with high risk for diabetes (OR, 2.912; 95% CI: 1.009 − 8.402). "
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    BMC Public Health 07/2013; 13(1):633. DOI:10.1186/1471-2458-13-633 · 2.26 Impact Factor
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    • "The prevalence of diabetes mellitus in our study (7.69%) was comparable to that previously published in the literature [40,41]. Demonstrating a range in published data, one previous population based study conducted in a semi-urban community of Nepal, found a lower prevalence of 4.1% [42], while other studies from the region have presented a higher prevalence [41,43]. "
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