Risk factors for diabetic retinopathy among Saudi diabetics.
OBJECTIVE
To describe the incidence of, and risk factors associated with, diabetic retinopathy in diabetic persons assessed at a Saudi diabetes centre.


METHODS
Five hundred and two patients with diabetes mellitus assessed by our service were studied. There were 174 patients (34.7%) with insulin-dependent diabetes mellitus (IDDM) and 328 patients (65.3%) with non-insulin-dependent diabetes mellitus (NIDDM).


RESULTS
The incidence of retinopathy was 157/502 (31.3%). The incidence was 42.5% in patients with IDDM and 25.3% in those with NIDDM. By logistic regression analysis, it was shown that old age (>60 years), insulin use, long duration of diabetes (>10 years), poor diabetes control, and the presence of nephropathy were significantly associated with the incidence of retinopathy. On the basis of the magnitudes of the regression coefficients in the hazard function, long duration of diabetes was the most important independent risk factor for the development of retinopathy; the presence of nephropathy, age >60 years, poor diabetes control, and use of insulin were less important (regression coefficients: 1.9, 1.71, 1.331, 0.8508 and 0.6178, respectively). The incidence of macular oedema was significantly associated with the presence of hypertension and high cholesterol levels in patients with IDDM. Polycotomous regression analysis showed that the presence of nephropathy was the only factor significantly associated with the severity of retinopathy.


CONCLUSIONS
The significant associations with poor control and duration of diabetes provide further strong evidence for the benefits of optimal glycaemic control. Other potentially modifiable risk factors for retinopathy may be important, including elevated blood pressure and serum cholesterol.
El-Asrar
A M
AM
Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia. Abuasrar@KSU.edu.sa
Al-Rubeaan
K A
KA
Al-Amro
S A
SA
Kangave
D
D
Moharram
O A
OA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism; D002648:Child; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D003930:Diabetic Retinopathy / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D012529:Saudi Arabia / Q000453:epidemiology; D012720:Severity of Illness Index; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D014280:Triglycerides; D002784:Cholesterol