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Prevalence and risk factors for diabetic retinopathy: the Singapore Malay Eye Study.
Ophthalmology 2008; 115(11):1869-75O

Abstract

PURPOSE

To describe the prevalence and risk factors of diabetic retinopathy in Asian Malays.

DESIGN

Population-based cross-sectional study.

PARTICIPANTS

Persons with diabetes of Malay ethnicity aged 40 to 80 years in Singapore.

METHODS

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.

MAIN OUTCOME MEASURES

Any diabetic retinopathy, retinopathy grades, macular edema, or vision-threatening retinopathy.

RESULTS

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.

CONCLUSIONS

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.

Authors+Show Affiliations

Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18584872

Citation

Wong, Tien Y., et al. "Prevalence and Risk Factors for Diabetic Retinopathy: the Singapore Malay Eye Study." Ophthalmology, vol. 115, no. 11, 2008, pp. 1869-75.
Wong TY, Cheung N, Tay WT, et al. Prevalence and risk factors for diabetic retinopathy: the Singapore Malay Eye Study. Ophthalmology. 2008;115(11):1869-75.
Wong, T. Y., Cheung, N., Tay, W. T., Wang, J. J., Aung, T., Saw, S. M., ... Mitchell, P. (2008). Prevalence and risk factors for diabetic retinopathy: the Singapore Malay Eye Study. Ophthalmology, 115(11), pp. 1869-75. doi:10.1016/j.ophtha.2008.05.014.
Wong TY, et al. Prevalence and Risk Factors for Diabetic Retinopathy: the Singapore Malay Eye Study. Ophthalmology. 2008;115(11):1869-75. PubMed PMID: 18584872.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence and risk factors for diabetic retinopathy: the Singapore Malay Eye Study. AU - Wong,Tien Y, AU - Cheung,Ning, AU - Tay,Wan Ting, AU - Wang,Jie Jin, AU - Aung,Tin, AU - Saw,Seang Mei, AU - Lim,Su Chi, AU - Tai,E Shyong, AU - Mitchell,Paul, Y1 - 2008/06/26/ PY - 2008/01/14/received PY - 2008/04/27/revised PY - 2008/05/06/accepted PY - 2008/7/1/pubmed PY - 2008/12/31/medline PY - 2008/7/1/entrez SP - 1869 EP - 75 JF - Ophthalmology JO - Ophthalmology VL - 115 IS - 11 N2 - PURPOSE: To describe the prevalence and risk factors of diabetic retinopathy in Asian Malays. DESIGN: Population-based cross-sectional study. PARTICIPANTS: Persons with diabetes of Malay ethnicity aged 40 to 80 years in Singapore. METHODS: 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. MAIN OUTCOME MEASURES: Any diabetic retinopathy, retinopathy grades, macular edema, or vision-threatening retinopathy. RESULTS: 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. CONCLUSIONS: 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. SN - 1549-4713 UR - https://www.unboundmedicine.com/medline/citation/18584872/Prevalence_and_risk_factors_for_diabetic_retinopathy:_the_Singapore_Malay_Eye_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(08)00452-1 DB - PRIME DP - Unbound Medicine ER -