title: The Associations of Dietary Intake of Polyunsaturated Fatty Acids With Diabetic Retinopathy in Well-Controlled Diabetes.
abstract: OBJECTIVE
  To assess the associations between dietary intake of polyunsaturated fatty acids (PUFAs) and diabetic retinopathy (DR).
  
  
  METHODS
  This was a cross-sectional study of 379 patients (median age: 66.0 years) with diabetes attending a diabetes eye clinic. Daily fatty acid intake was assessed by using a validated Food Frequency Questionnaire and adjusted for energy intake. Diabetic retinopathy was graded from fundus photographs as no DR, nonproliferative DR, or proliferative DR. Patients were categorized as "well-controlled diabetes" (n = 123) and "poorly controlled diabetes" (n = 256), defined as glycated hemoglobin (HbA1c) level < 7.0% or ≥ 7.0%, respectively.
  
  
  RESULTS
  There were no associations between any fatty acid intake and DR. However, among patients with well-controlled diabetes, increasing daily intake of PUFAs was associated with a reduced likelihood of the presence (odds ratio [OR]: 0.18; 95% confidence interval [CI]: 0.06-0.59) and severity of DR after adjusting for age, sex, HbA1c, mean arterial blood pressure, and duration of diabetes. Moreover, an increased saturated fatty acid (SFA) intake was associated with increased likelihood of the presence (OR: 2.37; 95% CI: 1.15-4.88) and severity of DR. No association was found among those with poorly controlled diabetes.
  
  
  CONCLUSIONS
  Increasing PUFA intake was associated with a reduced likelihood of the presence and severity of DR in well-controlled diabetes, whereas increasing SFA intake was associated with an increased likelihood of the presence and severity of DR. Further studies to confirm this observation are warranted to elucidate the underlying mechanisms and potential role of dietary PUFA and SFA intake in the management of DR.
authors.affiliation: Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Department of Ophthalmology, Melbourne University, Victoria, Australia 2Department of Ophthalmology, Tachikawa Hospital, Tokyo, Japan 3National Institute of Sensory Organs, National.
authors.forename: Mariko
authors.initials: M
authors.lastname: Sasaki
authors.affiliation: Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Department of Ophthalmology, Melbourne University, Victoria, Australia 5Department of Public Health, Yamagata University Faculty of Medicine, Yamagata, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Kawasaki
authors.affiliation: Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Department of Ophthalmology, Melbourne University, Victoria, Australia.
authors.forename: Sophie
authors.initials: S
authors.lastname: Rogers
authors.affiliation: Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Department of Ophthalmology, Melbourne University, Victoria, Australia 6Singapore Eye Research Institute, National University of Singapore, Singapore.
authors.forename: Ryan Eyn Kidd
authors.initials: RE
authors.lastname: Man
authors.affiliation: Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Department of Ophthalmology, Melbourne University, Victoria, Australia.
authors.forename: Katsumasa
authors.initials: K
authors.lastname: Itakura
authors.affiliation: Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Department of Ophthalmology, Melbourne University, Victoria, Australia.
authors.forename: Jing
authors.initials: J
authors.lastname: Xie
authors.affiliation: Faculty of Health Sciences, University of Sydney, Sydney, Australia 8St. Vincent's Hospital, Sydney, Australia.
authors.forename: Victoria
authors.initials: V
authors.lastname: Flood
authors.affiliation: Department of Ophthalmology, Keio University, Tokyo, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tsubota
authors.affiliation: Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Department of Ophthalmology, Melbourne University, Victoria, Australia 6Singapore Eye Research Institute, National University of Singapore, Singapore 9Duke-NUS Graduate Medical Schoo.
authors.forename: Ecosse
authors.initials: E
authors.lastname: Lamoureux
authors.affiliation: Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Department of Ophthalmology, Melbourne University, Victoria, Australia 10Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute for Medical Researc.
authors.forename: Jie Jin
authors.initials: JJ
authors.lastname: Wang
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003930:Diabetic Retinopathy / Q000097:blood / Q000178:diet therapy* / Q000503:physiopathology; D002149:Energy Intake; D005231:Fatty Acids, Unsaturated / Q000494:pharmacology*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D005231:Fatty Acids, Unsaturated; D006442:Glycated Hemoglobin