title: The relationship of retinopathy in persons without diabetes to the 15-year incidence of diabetes and hypertension: Beaver Dam Eye Study.
abstract: OBJECTIVE
  To examine the relationship of retinopathy in persons without diabetes mellitus to the 15-year cumulative incidence of diabetes mellitus and hypertension.
  
  
  METHODS
  A total of 3,402 persons 43 to 86 years of age without diabetes mellitus (1,879 without diabetes or hypertension) at the time of a baseline examination in 1988-1990 had follow-up examinations in 1993-1995, 1998-2000, and/or 2003-2005. Diabetes mellitus was defined by a combination of history, serum glucose levels, and glycosylated hemoglobin levels, and hypertension was defined as systolic blood pressure >/=140 mm Hg or diastolic blood pressure >/=90 mm Hg and/or use of antihypertensive medications. Retinopathy at baseline was determined by masked gradings of stereoscopic fundus photographs using standardized protocols.
  
  
  RESULTS
  Retinopathy was present in 7.3% of the nondiabetic persons in the cohort and 5.4% of the nondiabetic, nonhypertensive cohort at baseline. The 15-year cumulative incidence of diabetes was 12.5% and of hypertension 54.1%. While controlling for age, persons with retinopathy were more likely to develop diabetes mellitus (odds ratio, 95% confidence interval, P value: 1.70, 1.17-2.48, P = .005) and hypertension (1.62, 1.18-2.23, P = .003) than persons without retinopathy. While controlling for other risk factors (eg, blood pressure, glucose level, cardiovascular disease history), the associations of retinopathy with incident diabetes mellitus (1.35, 0.90-2.03, P = .15) and hypertension (1.48, 1.05-2.07, P = .02) became attenuated but remained statistically significant for hypertension. In stratified analyses, retinopathy was associated with incident diabetes in persons younger than 65 years (1.80, 1.12-2.89, P = .02)
  
  
  CONCLUSIONS
  While controlling for other risk factors, retinopathy in nondiabetic individuals is associated with the incidence of hypertension and, in younger persons, with the incidence of diabetes mellitus.
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA.
authors.forename: Ronald
authors.initials: R
authors.lastname: Klein
authors.forename: Barbara E K
authors.initials: BE
authors.lastname: Klein
authors.forename: Scot E
authors.initials: SE
authors.lastname: Moss
authors.forename: Tien Y
authors.initials: TY
authors.lastname: Wong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D001795:Blood Pressure Determination; D002784:Cholesterol / Q000097:blood; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology*; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014922:Wisconsin / Q000453:epidemiology
chemical_list: D001786:Blood Glucose; D002784:Cholesterol; D006442:Glycated Hemoglobin