title: Risk Factors for Proliferative Diabetic Retinopathy in African Americans with Type 2 Diabetes.
abstract: OBJECTIVE
  To assess personal and demographic risk factors for proliferative diabetic retinopathy in African Americans with type 2 diabetes.
  
  
  METHODS
  In this prospective, non-interventional, cross-sectional case-control study, 380 African Americans with type 2 diabetes were enrolled. Participants were recruited prospectively and had to have either: (1) absence of diabetic retinopathy after ≥10 years of type 2 diabetes, or (2) presence of proliferative diabetic retinopathy when enrolled. Dilated, 7-field fundus photographs were graded using the Early Treatment Diabetic Retinopathy Study scale. Covariates including hemoglobin A1C (HbA1C), blood pressure, height, weight and waist circumference were collected prospectively. Multivariate regression models adjusted for age, sex and site were constructed to assess associations between risk factors and proliferative diabetic retinopathy.
  
  
  RESULTS
  Proliferative diabetic retinopathy was associated with longer duration of diabetes (odds ratio, OR, 1.62, p < 0.001), higher systolic blood pressure (OR 1.65, p < 0.001) and insulin use (OR 6.65, p < 0.001) in the multivariate regression analysis. HbA1C was associated with proliferative diabetic retinopathy in the univariate analysis (OR 1.31, p = 0.002) but was no longer significant in the multivariate analysis.
  
  
  CONCLUSIONS
  In this case-control study of African Americans with type 2 diabetes, duration of diabetes, systolic hypertension and insulin use were strong risk factors for the development of proliferative diabetic retinopathy. Interestingly, HbA1C did not confer additional risk in this cohort.
authors.affiliation: a Department of Medicine , University of Mississippi Medical Center , Jackson , MS , USA.|b Center of Biostatistics and Bioinformatics , University of Mississippi Medical Center , Jackson , MS , USA.
authors.forename: Alan
authors.initials: A
authors.lastname: Penman
authors.affiliation: c Department of Ophthalmology , University of Mississippi Medical Center , Jackson , MS , USA.
authors.forename: Heather
authors.initials: H
authors.lastname: Hancock
authors.affiliation: d Department of Ophthalmology , Harvard Medical School, Massachusetts Eye and Ear Infirmary , Boston , MA , USA.
authors.forename: Evangelia
authors.initials: E
authors.lastname: Papavasileiou
authors.affiliation: e Department of Ophthalmology , St Dominic's Hospital , Jackson , MS , USA.
authors.forename: Maurice
authors.initials: M
authors.lastname: James
authors.affiliation: c Department of Ophthalmology , University of Mississippi Medical Center , Jackson , MS , USA.
authors.forename: Omolola
authors.initials: O
authors.lastname: Idowu
authors.affiliation: a Department of Medicine , University of Mississippi Medical Center , Jackson , MS , USA.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Riche
authors.affiliation: f Center for Human Genetic Research , Massachusetts General Hospital , Boston , MA , USA.
authors.forename: Marlene
authors.initials: M
authors.lastname: Fernandez
authors.affiliation: d Department of Ophthalmology , Harvard Medical School, Massachusetts Eye and Ear Infirmary , Boston , MA , USA.
authors.forename: Stacey
authors.initials: S
authors.lastname: Brauner
authors.affiliation: c Department of Ophthalmology , University of Mississippi Medical Center , Jackson , MS , USA.
authors.forename: Sataria O
authors.initials: SO
authors.lastname: Smith
authors.affiliation: c Department of Ophthalmology , University of Mississippi Medical Center , Jackson , MS , USA.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Hoadley
authors.affiliation: c Department of Ophthalmology , University of Mississippi Medical Center , Jackson , MS , USA.
authors.forename: Cole
authors.initials: C
authors.lastname: Richardson
authors.affiliation: g Department of Ophthalmology , Boston Medical Center , Boston , MA , USA.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Vazquez
authors.affiliation: g Department of Ophthalmology , Boston Medical Center , Boston , MA , USA.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Chi
authors.affiliation: h Visual Services Department , Harvard Vanguard Medical Associates , Boston , MA , USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Andreoli
authors.affiliation: d Department of Ophthalmology , Harvard Medical School, Massachusetts Eye and Ear Infirmary , Boston , MA , USA.
authors.forename: Deeba
authors.initials: D
authors.lastname: Husain
authors.affiliation: c Department of Ophthalmology , University of Mississippi Medical Center , Jackson , MS , USA.
authors.forename: Ching J
authors.initials: CJ
authors.lastname: Chen
authors.affiliation: i Harvard Medical School , Massachusetts Eye and Ear Infirmary , Boston , MA , USA.
authors.forename: Lucia
authors.initials: L
authors.lastname: Sobrin
mesh_terms: D001741:Black or African American / Q000208:ethnology*; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D001837:Body Weights and Measures; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology*; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000208:ethnology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: African Americans; diabetic retinopathy; proliferative diabetic retinopathy; risk factors; type 2 diabetes