Relationship between HbA1c and risk of retinal hemorrhage in the Japanese general population: The Circulatory Risk in Communities Study (CIRCS).
Retinal hemorrhage is an important finding on fundus photography. Diabetes mellitus is a cause of retinal hemorrhage, although other causes exist. We sought to better characterize the association between retinal hemorrhage and HbA1c in the Japanese population.



We conducted a prospective study of 11,644 Japanese men and women aged 30-78years between 2001 and 2011. Fundus photography was performed as part of an annual cardiovascular disease risk survey. HbA1c was determined by the latex coagulation method throughout the study. We used logistic regression models to examine the association between HbA1c and the risk of retinal hemorrhage and diabetic retinal hemorrhage.



During a median follow-up period of 4.6years, 509 retinal hemorrhages, including 96 diabetic retinal hemorrhages, were diagnosed. HbA1c was positively associated with the risk of retinal hemorrhage and diabetic retinal hemorrhage among subjects not taking medication for diabetes mellitus at baseline, but not among subjects who were taking medication at baseline.



HbA1c was positively associated with the risk of retinal hemorrhage and the subcategory of diabetic retinal hemorrhage among subjects not taking medication for diabetes mellitus at baseline. The association was evident for diabetic retinal hemorrhage, compared with retinal hemorrhage.
Department of Public Health, Dokkyo Medical University, School of Medicine, Mibu, Japan; Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan; Department of Public Health Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Mitsumasa
M
Umesawa
Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan; Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan. Electronic address: kitamura@pbhel.med.osaka-u.ac.jp.
Akihiko
A
Kitamura
Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan.
Masahiko
M
Kiyama
Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan.
Takeo
T
Okada
Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
Hironori
H
Imano
Department of Epidemiology, Fukushima Medical University, Fukushima, Japan.
Tetsuya
T
Ohira
Department of Public Health Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Kazumasa
K
Yamagishi
Department of Basic Nursing and Health Science, Ehime University Graduate School of Medicine, Toon, Japan.
Isao
I
Saito
Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
Hiroyasu
H
Iso
D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D058065:Diabetic Cardiomyopathies / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D003930:Diabetic Retinopathy / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis*; D006306:Health Surveys; D006801:Humans; D006943:Hyperglycemia / Q000503:physiopathology*; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012166:Retinal Hemorrhage / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors
D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
Diabetes mellitus; General population; HbA1c; Prospective study; Retinal hemorrhage