title: Associations between diabetic retinopathy and systemic risk factors.
abstract: BACKGROUND
  Diabetes mellitus is a systemic disease with complications that include sight-threatening diabetic retinopathy. It is essential to understand the risk factors of diabetic retinopathy before effective prevention can be implemented. The aim of this review was to examine the association between diabetic retinopathy and systemic risk factors.
  
  
  METHODS
  A PubMed literature search was performed up to May 2016 to identify articles reporting associations between diabetic retinopathy and systemic risk factors; only publications written in English were included. Relevant articles were selected and analysed.
  
  
  RESULTS
  Patients with diabetic retinopathy were more likely to have poor glycaemic control as reflected by a higher glycated haemoglobin, longer duration of diabetes, and use of insulin therapy for treatment. For other systemic risk factors, hypertension was positively associated with prevalence and progression of diabetic retinopathy. No clear association between obesity, hyperlipidaemia, gender, or smoking with diabetic retinopathy has been established as studies reported inconsistent findings. Myopia was a protective factor for the development of diabetic retinopathy. Several genetic polymorphisms were also found to be associated with an increased risk of development of diabetic retinopathy.
  
  
  CONCLUSIONS
  Good glycaemic and blood pressure control remain the most important modifiable risk factors to reduce the risk of progression of diabetic retinopathy and vision loss.
authors: Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong.
authors: N
authors: N
authors: Wat
authors: Hong Kong Eye Hospital, Argyle Street, Hong Kong.
authors: R Lm
authors: RL
authors: Wong
authors: Department of Ophthalmology, The University of Hong Kong, Pokfulam, Hong Kong.
authors: I Yh
authors: IY
authors: Wong
mesh_terms: D001766:Blindness / Q000209:etiology; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D003930:Diabetic Retinopathy / Q000188:drug therapy* / Q000453:epidemiology*; D018450:Disease Progression; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology*; D006973:Hypertension / Q000453:epidemiology*; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000008:administration & dosage; D009765:Obesity / Q000453:epidemiology*; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D012737:Sex Factors
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin
keywords: Blood pressure; Diabetes mellitus, type 2; Diabetic retinopathy; Hypertension; Risk factors