title: Blood pressure, lipids, and obesity are associated with retinopathy: the hoorn study.
abstract: OBJECTIVE
  To study potential risk factors for retinopathy in diabetic and nondiabetic individuals.
  
  
  METHODS
  The Hoorn Study is a population-based study including 2,484 50- to 74-year-old Caucasians. A subsample of 626 individuals stratified by age, sex, and glucose tolerance underwent extensive measurements during 1989-1992, including ophthalmologic examination and two-field 45-degree fundus photography. The prevalence of (diabetic) retinopathy was assessed among individuals with normal glucose metabolism (NGM) and impaired glucose metabolism (IGM) and individuals with newly diagnosed diabetes mellitus (NDM) and known diabetes mellitus (KDM) (new World Health Organization 1999 criteria).
  
  
  RESULTS
  The prevalence of retinopathy was 9% in NGM, 11% in IGM, 13% in NDM, and 34% in KDM. Retinopathy worse than minimal nonproliferative diabetic retinopathy was present in 8% in KDM and 0-2% in other glucose categories. The prevalence of retinopathy was positively associated with elevated blood pressure, BMI, cholesterol, and triglyceride serum levels in all glucose categories. The age-, sex-, and glucose metabolism category-adjusted odds ratios were 1.5 (95% CI 1.2-1.9), 1.3 (1.0-1.7), and 1.3 (1.0-1.6) per SD increase of systolic blood pressure, BMI, and total cholesterol concentration, respectively, and 1.2 (1.0-1.5) per 50% increase of triglyceride level. Elevated blood pressure and plasma total and LDL cholesterol levels showed associations with retinal hard exudates.
  
  
  CONCLUSIONS
  Retinopathy is a multifactorial microvascular complication, which, apart from hyperglycemia, is associated with blood pressure, lipid concentrations, and BMI.
authors.affiliation: Department of Ophthalmology, VU University Medical Center, Amsterdam, The Netherlands. ha.vanleiden@vumc.nl
authors.forename: Hendrik A
authors.initials: HA
authors.lastname: van Leiden
authors.forename: Jacqueline M
authors.initials: JM
authors.lastname: Dekker
authors.forename: Annette C
authors.initials: AC
authors.lastname: Moll
authors.forename: Giel
authors.initials: G
authors.lastname: Nijpels
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Heine
authors.forename: Lex M
authors.initials: LM
authors.lastname: Bouter
authors.forename: Coen D A
authors.initials: CD
authors.lastname: Stehouwer
authors.forename: Bettine C P
authors.initials: BC
authors.lastname: Polak
mesh_terms: D000368:Aged; D001794:Blood Pressure; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood*; D003920:Diabetes Mellitus / Q000453:epidemiology*; D003930:Diabetic Retinopathy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009765:Obesity; D015995:Prevalence; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood*
chemical_list: D014280:Triglycerides; D002784:Cholesterol