title: Risk factors of diabetic retinopathy in Bangladeshi type 2 diabetic patients.
abstract: OBJECTIVE
  To determine the risk factors associated with diabetic retinopathy (DR) in Bangladeshi type 2 diabetic subjects.
  
  
  METHODS
  A cohort of 977 type-2 diabetic patients was recruited retrospectively based on hospital records in 2008, who were naïve type-2 diabetes during 1993. Data on diabetes and lipid profile with serum creatinine and biophysical measures were obtained at baseline, 5, 10 and 15 years. DR was diagnosed by retinal color photography. Generalized linear models were used to assess the associations of clinical, biochemical and anthropometric variables with retinopathy at three follow-up. Cumulative exposures were determined based on average exposure to individual attribute. IRR and 95% CI were generated through Poisson regression model, adjusting for age-at-diagnosis of diabetes, baseline BMI, end-line waist-to-hip ratio and present physical activity status.
  
  
  RESULTS
  DR patients had significantly poorer glycemic control at all three follow-ups. Age, residence, physical activity, serum creatinine and hypertension appeared as independent risk factors for DR in all three follow-up points. Poisson regression model identified glucose deregulation (IRR 1.8; CI 1.5-2.1), hypertension (IRR 1.5; CI 1.2-1.8) and raised serum creatinine (IRR 1.9; CI 1.5-2.3) as significant predictors for DR adjusted for possible confounders. Work related moderate-to-heavy physical activity (IRR 0.2; CI 0.1-0.3) appeared as protective.
  
  
  CONCLUSIONS
  Along with poor glycemic control, hypertension, nephropathy are independent risk factor retinopathy.
authors.affiliation: Bangladesh Institute of Health Sciences (BIHS), Department of Health Promotion and Health Education, Dhaka, Bangladesh; Institute of Health and Society, Department of Community Medicine, University of Oslo, Norway.
authors.forename: Kazi R
authors.initials: KR
authors.lastname: Ahmed
authors.affiliation: World Health Organization, NCD Unit, Bangladesh.
authors.forename: Md N
authors.initials: MN
authors.lastname: Karim
authors.affiliation: BRAC Health Program, BRAC, Bangladesh.
authors.forename: Mohammad S
authors.initials: MS
authors.lastname: Bukht
authors.affiliation: Institute of Health and Society, Department of Community Medicine, University of Oslo, Norway.
authors.forename: Bishwajit
authors.initials: B
authors.lastname: Bhowmik
authors.affiliation: Bangladesh Institute of Health Sciences (BIHS), Department of Community Medicine, Dhaka, Bangladesh.
authors.forename: Amitava
authors.initials: A
authors.lastname: Acharyya
authors.affiliation: Bangladesh Institute of Health Sciences (BIHS), Department of Health Promotion and Health Education, Dhaka, Bangladesh.
authors.forename: Liaquat
authors.initials: L
authors.lastname: Ali
authors.affiliation: Institute of Health and Society, Department of Community Medicine, University of Oslo, Norway.
authors.forename: Akhtar
authors.initials: A
authors.lastname: Hussain
mesh_terms: D000328:Adult; D001459:Bangladesh / Q000453:epidemiology; D001794:Blood Pressure; D003404:Creatinine / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D003930:Diabetic Retinopathy / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D008055:Lipids; D003404:Creatinine