title: Prevalence and associations of diabetic retinopathy in a large cohort of prediabetic subjects: the Gutenberg Health Study.
abstract: OBJECTIVE
  To evaluate the prevalence of diabetic retinopathy/maculopathy (DR/DMac) and its associations with cardiovascular risk factors (CRF) in participants with prediabetes (PwPD) in a large European cohort within the population-based Gutenberg Health Study (GHS).
  
  
  METHODS
  The study was based on a sub-cohort of the GHS (n=5,000, age: 35-74 y). Prediabetes was diagnosed according to HbA1c levels (5.7-6.4%). DR/DMac was graded from fundus photographs. Blood samples and comprehensive questionnaires served for evaluation of laboratory results and CRF.
  
  
  RESULTS
  The prevalence of prediabetes was 22.4%, and of DR/DMac 8.1%/0.2%, respectively. The majority of participants had mild DR (7.2%). A percentage of 0.5 of PwPD presented with moderate and 0.3% with severe non-proliferative disease. None of the subjects had proliferative DR. No independent association was found between any of the analyzed CRF [hypertension, smoking, (family) history of myocardial infarction, congestive heart failure, coronary heart disease, stroke, obesity, dyslipidemia, chronic obstructive pulmonary disease, peripheral artery disease and chronic kidney disease] and DR.
  
  
  CONCLUSIONS
  Although prevalences of prediabetes and DR in this Caucasian cohort are considerable, retinopathy findings are mainly mild, and no association was found for DR/DMac and CRF.
authors.affiliation: Department of Ophthalmology, University Medical Centre Mainz, Mainz/Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Lamparter
authors.affiliation: Department of Ophthalmology, University Medical Centre Mainz, Mainz/Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Raum
authors.affiliation: Department of Ophthalmology, University Medical Centre Mainz, Mainz/Germany.
authors.forename: Norbert
authors.initials: N
authors.lastname: Pfeiffer
authors.affiliation: NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London/UK.
authors.forename: Tunde
authors.initials: T
authors.lastname: Peto
authors.affiliation: Department of Ophthalmology, University Medical Centre Mainz, Mainz/Germany.
authors.forename: René
authors.initials: R
authors.lastname: Höhn
authors.affiliation: Department of Ophthalmology, University Medical Centre Mainz, Mainz/Germany.
authors.forename: Heike
authors.initials: H
authors.lastname: Elflein
authors.affiliation: Department of Medicine 2, University Medical Center Mainz, Germany; Center for Thrombosis and Hemostasis, University Medical Center Mainz, Germany; German Center for Cardiovascular Research (DZHK), University Medical Center Mainz, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Wild
authors.affiliation: Department of Medicine 2, University Medical Center Mainz, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Schulz
authors.affiliation: Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre Mainz, Mainz/Germany.
authors.forename: Astrid
authors.initials: A
authors.lastname: Schneider
authors.affiliation: Department of Ophthalmology, University Medical Centre Mainz, Mainz/Germany.
authors.forename: Alireza
authors.initials: A
authors.lastname: Mirshahi
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000150:complications / Q000453:epidemiology; D015331:Cohort Studies; D003925:Diabetic Angiopathies / Q000150:complications / Q000453:epidemiology; D058065:Diabetic Cardiomyopathies / Q000150:complications / Q000453:epidemiology; D003930:Diabetic Retinopathy / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D005858:Germany / Q000453:epidemiology; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008268:Macular Degeneration / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000097:blood / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D015995:Prevalence; D012160:Retina / Q000473:pathology*; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: Cardiovascular risk factors; Diabetic maculopathy; Diabetic retinopathy; Prediabetes; Screening