First Author: H.Ra SOUTH KOREA
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Our study was performed to determine whether visceral adiposity (VAT) or subcutaneous adiposity (SAT) was associated with diabetic retinopathy (DR) and clinically significant macular edema (CSME) in people with type 2 DM.
Retrospective cohort study.
Eight hundred and seventy-nine people with type 2 DM and who had undergone abdominal computed tomography assessment of the SAT and VAT areas were included. DR was graded from fundus photographs and classified into mild, moderate, severe nonproliferative, and proliferative DR and separately graded for the presence of clinically significant macular edema (CSME).
DR and CSME were present in 256 (29.1%), and 64 (7.3%) patients, respectively. SAT was not significantly associated with DR. In multivariate models adjusted for traditional risk factors, persons with higher SAT were more likely to have CSME (OR, 1.34; 95% CI, 1.06–1.75; P = 0.012). And persons with higher VAT were more likely to have DR (OR, 1.45; 95% CI, 1.12–1.87; P = 0.006) and CSME (OR, 1.56; 95% CI, 1.24–1.97; P = 0.001). When stratifying the individuals by the body mass index groups, VAT was independently associated with DR in the overweight and obese subjects after adjustment for the clinical variables, while there was no significant association between the VAT and DR in the normal weight subjects. SAT was not significantly associated with DR in the normal weight, overweight and obese subjects.
Our data suggest that VAT and SAT may be an additional prognostic factor for CSME in type 2 DM and VAT was independently associated with DR especially in the overweight or obese subjects with type 2 DM.