title: Prevalence and associated risk indicators of retinopathy in a rural Bangladeshi population with and without diabetes.
abstract: OBJECTIVE
  To determine the prevalence of retinopathy among people with normal and abnormal glucose metabolism in a remote rural community of Bangladesh, and to identify the associated risk indicators for developing retinopathy in this population.
  
  
  METHODS
  A population-based cross-sectional study was conducted through screening in camp settings, which included a total of 836 participants (468 male and 368 female) aged 30 years or over. Retinopathy was determined by fundus photography. Anthropometric measures (body mass index and waist-to-hip ratio), oral glucose tolerance, glycosylated hemoglobin (HbA1c), blood pressure, lipid profile, serum creatinine and urine albumin creatinine ratio (UACR) were measured. Logistic regression analysis was used with adjustment for potential confounders.
  
  
  RESULTS
  The overall prevalence of retinopathy was 5.4% (95% confidence interval, CI, 3.9-6.9). The prevalence rates of retinopathy among diabetic, impaired glucose regulation and non-diabetic subjects were 21.6%, 13% and 3.5%, respectively. Adjusted odds ratios for retinopathy were 2.53 (95% CI 1.52-5.41) for abnormal glucose metabolism and 1.98 (95% CI 1.17-5.63), 1.74 (95% CI 1.09-3.02) and 1.63 (95% CI 1.08-3.12) for hypertension, HbA1c and UACR, respectively. Additionally, age, body mass index, triglyceride and total cholesterol were also found to be significant independent risk indicators for the occurrence of retinopathy in this population.
  
  
  CONCLUSIONS
  A high prevalence of retinopathy was observed in this rural Bangladeshi population. In addition to blood glucose control for diabetes, screening for hypertension, obesity, hyperlipidemia and proteinuria as well as adequate treatment of these risk indicators may prevent retinopathy in rural Bangladeshi populations.
authors.affiliation: Department of Epidemiology, Bangladesh Institute of Health Sciences (BIHS), Dhaka, Bangladesh.
authors.forename: Afroza
authors.initials: A
authors.lastname: Akhter
authors.forename: Kaniz
authors.initials: K
authors.lastname: Fatema
authors.forename: Sayed Foysal
authors.initials: SF
authors.lastname: Ahmed
authors.forename: Afsana
authors.initials: A
authors.lastname: Afroz
authors.forename: Liaquat
authors.initials: L
authors.lastname: Ali
authors.forename: Akhtar
authors.initials: A
authors.lastname: Hussain
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000175:diagnosis; D000886:Anthropometry; D001459:Bangladesh / Q000453:epidemiology; D001794:Blood Pressure; D003401:Creatine / Q000097:blood; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology*; D003930:Diabetic Retinopathy / Q000453:epidemiology*; D005260:Female; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D003401:Creatine; D006442:Glycated Hemoglobin; D008055:Lipids; C517652:hemoglobin A1c protein, human