Risk factors for proliferative diabetic retinopathy in a Latino American population

摘要

PURPOSE: To assess the personal and demographic risk factors for proliferative diabetic retinopathy in Latino Americans in Los Angeles County. METHODS: In this prospective, non-interventional, cross-sectional case control study, seven hundred and twenty-nine subjects from Los Angeles County University of Southern California Medical Center (LAC + USC), Los Angeles, CA, were enrolled. All patients were recruited prospectively from the LAC + USC Medical Center and affiliated clinics between June 2008 and June 2011. Complete personal data and results from systemic and ophthalmic examinations were collected for all enrolled subjects. Laboratory tests such as glycosylated hemoglobin, creatinine levels, and cholesterol levels were collected prospectively by drawing blood at the time of each patient's clinic visit. The main outcome measures were age, gender, type of diabetes mellitus (DM I or II) duration of diabetes mellitus, history of hypertension, history of insulin use, height, weight, and body mass index, smoking history, glycosylated hemoglobin, creatinine levels, and cholesterol levels. RESULTS: The mean age of subjects with no diabetic retinopathy was 56.38 years (SD, 10.16), whereas that of patients with proliferative diabetic retinopathy was 57.43 years (SD, 9.63). Parameters that conferred a statistically significant increased risk for proliferative diabetic retinopathy in the multivariate model included gender (men were at higher risk: odds ratio [OR], 4.11; 95% confidence interval [CI], 2.56-6.58), insulin use (OR, 1.85; 95% CI, 1.13-3.03), history of hypertension (OR, 1.64; 95% CI, 1.02-2.63), and duration (>25 years vs. 10-15 years) of diabetes (OR, 22.00; 95% CI, 9.76-49.60). CONCLUSION: In this case-control study in a Latino population, duration of diabetes and male gender were the strongest risk factor for the development of proliferative diabetic retinopathy followed by insulin use and hypertension. Interestingly, smoking and glycosylated hemoglobin levels did not confer additional significant risk in this cohort.