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Association of Generalized and Abdominal Obesity with Diabetic Retinopathy in Chinese Type 2 Diabetic Patients

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Abstract

Aims

Obesity has been proposed to promote the progression of diabetic retinopathy (DR), but previous studies have not shown consistent results. We aimed to explore the association between generalized and abdominal obesity and DR risk, and to assess the joint effect of these two different types of obesity on DR development.

Methods

A nested case–control study within a large prospective study on type 2 diabetes was conducted in communities in Huai’an City, Jiangsu Province, China. Cases were individuals who had diagnoses of DR during the 6-year follow-up. A total number of 1544 DR cases and 1:1 matched controls were included. Binomial and multinomial logistic regression models were used to investigate the effects of obesity on DR occurrence and DR severity.

Results

Compared with individuals in the first tertile of the baseline waist-to-hip ratio (WHR), subjects in the third tertile at baseline had significantly higher risk of DR (OR 1.44, 95% CI 1.17–1.78) during the follow-up period. Conversely, body mass index (BMI) (continuous) had an adjusted OR of 0.97 (95% CI 0.95–0.99) of developing DR. Individuals with low BMI and high WHR levels were identified as a high-risk population with a higher likelihood of developing DR (OR 1.65, 95% CI 1.17–2.33) than those in the lowest BMI category and simultaneously in the first WHR tertile.

Conclusions

Type 2 diabetic individuals with low BMI levels and high WHR levels had a significantly increased risk of developing DR which indicated that isolated abdominal obesity might be involved in the pathogenesis of DR.

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Acknowledgements

We would like to thank the patients and staff for their important contributions. This study was funded by Jiangsu Provincial Leading Talents and Innovation Team Program (K201105), Jiangsu Provincial Fifth “333 Project” (BRA2020090) and Jiangsu Provincial Health Commission 2020 Medical Research Project (M2020085).

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Author notes

  1. Jiaxian Chen and Yanan Wan contributed equally to this work.

Authors and Affiliations

  1. Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China

    Jiaxian Chen, Chong Shen & Ming Wu

  2. Department of Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China

    Yanan Wan, Jian Su, Zheng Zhu, Yu Qin, Lan Cui, Jinyi Zhou & Ming Wu

  3. Department of Chronic Disease Prevention and Control, Huai’an City Center for Disease Control and Prevention, Huai’an, 223001, China

    Engchun Pan, Jinbo Wen & Kai Wang

  4. Qingjiangpu District Center for Disease Control and Prevention, Huai’an, 223300, China

    Hao Yu

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  1. Jiaxian Chen
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Contributions

MW, JyZ, CS, YQ, ZZ, JS and YnW performed literature search, study design, data collection and data interpretation; JxC was involved in data collection, data interpretation, data analysis and writing; EcP, JbW, KW and HY carried out literature search and data collection; LC contributed to literature search, study design and data interpretation and MW, JyZ, JS, YnW and JxC had access to the raw data. MW had full access to all the data in the study and the final responsibility for the decision to submit for publication.

Corresponding author

Correspondence to Ming Wu.

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Ethical Standard Statement

Ethics approval for this study was granted by the Ethics Board of Jiangsu Provincial Center for Disease Control and Prevention.

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Informed consent was obtained from all patients included in the study. All participants signed an informed consent document before participation.

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This article belongs to the topical collection Eye Complications of Diabetes, managed by Giuseppe Querques.

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Chen, J., Wan, Y., Su, J. et al. Association of Generalized and Abdominal Obesity with Diabetic Retinopathy in Chinese Type 2 Diabetic Patients. Acta Diabetol 59, 359–367 (2022). https://doi.org/10.1007/s00592-021-01806-7

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