title: Association between alcohol consumption and diabetic retinopathy and visual acuity-the AdRem Study.
abstract: OBJECTIVE
  We investigated the association between alcohol consumption and diabetic retinopathy and deterioration of visual acuity in individuals with Type 2 diabetes.
  
  
  METHODS
  We conducted a cohort analysis of 1239 participants with Type 2 diabetes aged 55-81 years enrolled in the AdRem study, a sub-study of the Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation (ADVANCE) trial. Current and past consumption of wine, spirits and beer was measured by self-report. Moderate and heavy alcohol consumption was defined as 1-14 and >14 drinks/week, respectively. Diabetic retinopathy, measured by mydriatic stereoscopic seven-field retinal photography, was defined by a 2-step progression in the Early Treatment of Diabetic Retinopathy Study (ETDRS) score or the presence of any retinal vascular lesions. Deterioration of visual acuity was defined by a decrease of two lines in best vision in either eye, measured corrected, or through a pinhole using a Snellen chart.
  
  
  RESULTS
  In a mean follow-up of 5.5 years, we identified 182 participants with a 2-step progression in the ETDRS score, 640 participants with the presence of any retinal vascular lesions and 693 participants with a deterioration of visual acuity. Current moderate consumption of alcohol, compared with no current consumption, was not associated with presence or progression of diabetic retinopathy; however, it was associated with higher risk of deterioration of visual acuity (multivariable-adjusted OR 1.83; 95% CI 1.34-2.48; P<0.001).
  
  
  CONCLUSIONS
  Alcohol consumption is associated with increased risk of deterioration of visual acuity, but not with retinopathy in individuals with Type 2 diabetes.
authors.affiliation: MRC Epidemiology Unit, Institute of Metabolic Science, Cambridge, UK.
authors.forename: C C
authors.initials: CC
authors.lastname: Lee
authors.forename: R P
authors.initials: RP
authors.lastname: Stolk
authors.forename: A I
authors.initials: AI
authors.lastname: Adler
authors.forename: A
authors.initials: A
authors.lastname: Patel
authors.forename: J
authors.initials: J
authors.lastname: Chalmers
authors.forename: B
authors.initials: B
authors.lastname: Neal
authors.forename: N
authors.initials: N
authors.lastname: Poulter
authors.forename: S
authors.initials: S
authors.lastname: Harrap
authors.forename: M
authors.initials: M
authors.lastname: Woodward
authors.forename: M
authors.initials: M
authors.lastname: Marre
authors.forename: D E
authors.initials: DE
authors.lastname: Grobbee
authors.forename: J W
authors.initials: JW
authors.lastname: Beulens
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000503:physiopathology; D001208:Asia / Q000453:epidemiology; D001315:Australia / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000139:chemically induced / Q000453:epidemiology* / Q000503:physiopathology; D003930:Diabetic Retinopathy / Q000139:chemically induced / Q000453:epidemiology* / Q000503:physiopathology; D018450:Disease Progression; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009656:North America / Q000453:epidemiology; D016032:Randomized Controlled Trials as Topic; D014792:Visual Acuity / Q000502:physiology*