title: The metabolic syndrome and severity of diabetic retinopathy.
abstract: BACKGROUND
  While metabolic syndrome has been strongly implicated as a risk factor for macrovascular diseases, such as stroke and cardiovascular disease, its relationship with microvascular diseases, including diabetic retinopathy, has been less defined. The purpose of this pilot study was to investigate the association between metabolic syndrome and the presence and severity of diabetic retinopathy.
  
  
  METHODS
  A retrospective case-control chart review at the University of Iowa ophthalmology and primary care clinics included 100 patients with proliferative diabetic retinopathy (PDR), 100 patients with nonproliferative diabetic retinopathy (NPDR), 100 diabetic patients without diabetic retinopathy, and 100 nondiabetic patients who were randomly selected. Using the International Diabetes Foundation definition, the prevalence of metabolic syndrome and the number of components of metabolic syndrome were compared among these groups.
  
  
  RESULTS
  The prevalence of metabolic syndrome in patients with diabetes was 69.3%, which was significantly higher than that in patients without diabetes (27%; P<0.0001) (odds ratio [OR] =6.28; 95% confidence interval [CI]: 3.76-10.49; P=0.0004). However, there was no significant difference in the prevalence of metabolic syndrome between diabetics with and without diabetic retinopathy, with rates of 67.5% and 73%, respectively (P=0.36) (OR =0.77; 95% CI: 0.45-1.32; P=0.34). In addition, there was no significant difference between the PDR and NPDR groups, with rates of 63% and 72%, respectively (P=0.23) (OR =0.70; 95% CI: 0.38-1.30; P=0.26).
  
  
  CONCLUSIONS
  The metabolic syndrome was highly prevalent in patients with diabetes, but it was not associated with the presence or severity of retinopathy.
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, IA, USA ; Mayo Clinic, Rochester, MN, USA.
authors.forename: John J
authors.initials: JJ
authors.lastname: Chen
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, IA, USA ; Vitreoretinal Service, University of Iowa, Iowa City, IA, USA.
authors.forename: Lucas J
authors.initials: LJ
authors.lastname: Wendel
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, IA, USA.
authors.forename: Emily S
authors.initials: ES
authors.lastname: Birkholz
authors.affiliation: Department of Pathology, University of Southern California, USA.
authors.forename: John G
authors.initials: JG
authors.lastname: Vallone
authors.affiliation: Department of Ophthalmology, School of Public Health, University of California, Los Angeles, CA, USA ; Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA, USA.
authors.forename: Anne L
authors.initials: AL
authors.lastname: Coleman
authors.affiliation: Department of Biostatistics, University of California, Los Angeles, CA, USA.
authors.forename: Fei
authors.initials: F
authors.lastname: Yu
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, IA, USA ; Vitreoretinal Service, University of Iowa, Iowa City, IA, USA ; Omics Laboratory, University of Iowa, Iowa City, IA, USA.
authors.forename: Vinit B
authors.initials: VB
authors.lastname: Mahajan
keywords: BMI; diabetes; diabetic retinopathy; hypertension; metabolic syndrome; obesity