Ethnicity, race, and clinically significant macular edema in the Veterans Affairs Diabetes Trial (VADT).
OBJECTIVE
To determine risk factors in clinically significant macular edema (CSME) and if increased CSME in minorities is due to ethnicity or other factors in the Veterans Affairs Diabetes Trial (VADT).


METHODS
CSME prevalence based on 7-field stereo fundus photographs in 1268 patients with type 2 diabetes was related to ethnicity, demographics and biochemistries by univariate and multivariate analyses.


RESULTS
Hispanics (H) made up 17.5% and African Americans (AA) 17.7% of the cohort. CSME prevalence was 10%. In univariate analysis, CSME was more prevalent in H, 18%, and AA, 15.6% than in non-Hispanic Whites (NHW), 6.3%, p<0.01. Univariate regression of CSME associated with younger age, younger onset of diabetes; longer duration; retinopathy severity; and high HbA1c, BP, urine albumin/creatinine, and amputation, all p<0.01. In multivariate regression, CSME was associated with ethnicity/race (Hispanic White vs. non-Hispanic White, OR, (95% CI), 2.30, (1.35-3.92), p<0.01; African American vs. non-Hispanic White, 2.30, (1.33-4.00), p<0.01), diastolic BP (1.13 per 5 mm Hg, (1.02-1.23), p=0.03), amputation (3.0, (1.11-8.13), p=0.04), and retinopathy severity ( approximately 30, ( approximately 17 to approximately 59), p<0.01).


CONCLUSIONS
The prevalence of CSME in the VADT is associated with ethnicity as well as diastolic BP, amputation, and retinopathy severity.
Emanuele
Nicholas
N
Hines VA Hospital, Hines, IL, USA.
Moritz
Thomas
T
Klein
Ronald
R
Davis
Matthew D
MD
Glander
Kathleen
K
Khanna
Anuradha
A
Thottapurathu
Lizy
L
Bahn
Gideon
G
Duckworth
William
W
Abraira
Carlos
C
D017668:Age of Onset; D000368:Aged; D000671:Amputation, Surgical / Q000706:statistics & numerical data; D000704:Analysis of Variance; D048909:Diabetes Complications / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology*; D003925:Diabetic Angiopathies / Q000453:epidemiology; D005006:Ethnicity / Q000706:statistics & numerical data*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008269:Macular Edema / Q000453:epidemiology* / Q000208:ethnology; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D009204:Myocardial Revascularization / Q000706:statistics & numerical data; D018579:Patient Selection; D015995:Prevalence; D044469:Racial Groups / Q000208:ethnology / Q000706:statistics & numerical data*; D020521:Stroke / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data; D044465:White People / Q000706:statistics & numerical data
D006442:Glycated Hemoglobin