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Prevalence and Risk Factors of Diabetic Retinopathy in Diabetes People using Korean National Health and Nutrition Examination Survey VII

  • Received : 2022.09.23
  • Accepted : 2022.11.28
  • Published : 2022.12.31

Abstract

Purpose: This study aimed to investigate the prevalence and risk factors of diabetic retinopathy (DR) in people with diabetes mellitus (DM) using Korean National Health and Nutrition Examination Survey VII (2017~2018). Methods: DM was defined as in two ways; 1) doctor's diagnosis (Group 1, n=549), 2) one of doctor's diagnosis, medication, or hyperglycemia (Group 2, n=849). The DR prevalence was measured as the prevalence proportion (%). Risk factors for developing DR were analyzed using multiple logistic regression, and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Results: The prevalence of DR was 25.87% in Group 1 and 20.14% in Group 2. Risk factors for DR were identified as insulin therapy (Group 1: OR=5.31, Group 2: OR=5.27), DM duration ≥10 years (Group 1: OR=2.20, Group 2: OR=3.10), and systolic blood pressure ≥140 mmHg (Group 1: OR=2.26, Group 2: OR=2.23) for both groups. Conclusion: Considering the DR prevalence, eye examinations education is highly recommended as part of a diabetes management programs in the community. It is also proposed to shorten the eye examination cycle for people with risk factors and establish a referral system to link between screening to treatment.

Keywords

References

  1. Wong TY, Cheung CM, Larsen M, Sharma S, Simo R. Diabetic retinopathy. Nature Reviews Disease Primers. 2016;2:16012. https://doi.org/10.1038/nrdp.2016.12
  2. GBD 2019 Blindness and Vision Impairment Collaborators; Vision Loss Expert Group of the Global Burden of Disease Study. Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: The right to sight: An analysis for the global burden of disease study. The Lancet Global Health. 2021;9(2):e144-e160. https://doi.org/10.1016/S2214-109X(20)30489-7
  3. Faselis C, Katsimardou A, Imprialos K, Deligkaris P, Kallistratos M, Dimitriadis K. Microvascular complications of type 2 diabetes mellitus. Current Vascular Pharmacology. 2020;18(2): 117-124. https://doi.org/10.2174/1570161117666190502103733
  4. Teo ZL, Tham YC, Yu M, Chee ML, Rim TH, Cheung N, et al. Global Prevalence of Diabetic retinopathy and projection of burden through 2045: systematic review and meta-analysis. Ophthalmology. 2021;128(11):1580-1591. https://doi.org/10.1016/j.ophtha.2021.04.027
  5. Yang QH, Zhang Y, Zhang XM, Li XR. Prevalence of diabetic retinopathy, proliferative diabetic retinopathy and non-proliferative diabetic retinopathy in Asian T2DM patients: A systematic review and Meta-analysis. International Journal of Ophthalmology. 2019;12(2):302-311. https://doi.org/10.18240/ijo.2019.02.19
  6. Chung YR, Ha KH, Lee K, Kim DJ. Diabetic retinopathy and related clinical practice for people with diabetes in Korea: a 10-year trend analysis. Diabetes & Metabolism Journal. 2020; 44(6):928-932. https://doi.org/10.4093/dmj.2020.0096
  7. Korean diabetes association (KDA). Diabetes fact sheets in Korea 2020 [Internet]. Seoul: KDA; 2020 [cited 2022 Jan 27]. Available from: https://www.diabetes.or.kr/pro/news/admin.php?category=A&code=admin&number=1992&mode=view
  8. Song SJ, Han K, Choi KS, Ko SH, Rhee EJ, Park CY, et al. Trends in diabetic retinopathy and related medical practices among type 2 diabetes patients: Results from the National Insurance Service Survey 2006-2013. Journal of Diabetes Investigation. 2018;9(1):173-178. https://doi.org/10.1111/jdi.12655
  9. Chua J, Lim CXY, Wong TY, Sabanayagam C. Diabetic retinopathy in the Asia-Pacific. Asia-Pacific Journal of Ophthalmology. 2018;7(1):3-16. https://doi.org/10.22608/APO.2017511
  10. Cui J, Ren JP, Chen DN, Xin Z, Yuan MX, Xu J, et al. Prevalence and associated factors of diabetic retinopathy in Beijing, China: A cross-sectional study. BMJ Open. 2017;7(8):e015473. https://doi.org/10.1136/bmjopen-2016-015473
  11. Euswas N, Phonnopparat N, Morasert K, Thakhampaeng P, Kaewsanit A, Mungthin M, et al. National trends in the prevalence of diabetic retinopathy among Thai patients with type 2 diabetes and its associated factors from 2014 to 2018. PLoS One. 2021;16(1):e0245801. https://doi.org/10.1371/journal.pone.0245801
  12. Song P, Yu J, Chan KY, Theodoratou E, Rudan I. Prevalence, risk factors and burden of diabetic retinopathy in China: A systematic review and meta-analysis. Journal of Global Health. 2018;8(1):010803. https://doi.org/10.7189/jogh.08.010803
  13. Sun Q, Jing Y, Zhang B, Gu T, Meng R, Sun J, et al. The risk factors for diabetic retinopathy in a Chinese population: A cross-sectional study. Journal of Diabetes Research. 2021;2021: 5340453. https://doi.org/10.1155/2021/5340453
  14. Tan GS, Gan A, Sabanayagam C, Tham YC, Neelam K, Mitchell P, et al. Ethnic differences in the prevalence and risk factors of diabetic retinopathy: The Singapore epidemiology of eye diseases study. Ophthalmology. 2018;125(4):529-536. https://doi.org/10.1016/j.ophtha.2017.10.02
  15. Ting DS, Cheung GC, Wong TY. Diabetic retinopathy: global prevalence, major risk factors, screening practices and public health challenges: a review. Clinical & Experimental Ophthalmology. 2016;44(4):260-277. https://doi.org/10.1111/ceo.12696
  16. Wat N, Wong RL, Wong IY. Associations between diabetic retinopathy and systemic risk factors. Hong Kong Medical Journal. 2016;22(6):589-599. https://doi.org/10.12809/hkmj164869
  17. Yin L, Zhang D, Ren Q, Su X, Sun Z. Prevalence and risk factors of diabetic retinopathy in diabetic patients: A community based cross-sectional study. Medicine (Baltimore). 2020;99(9):e19236. https://doi.org/10.1097/MD.0000000000019236
  18. World Health Organization (WHO). A conceptual framework for action on the social determinants of health [Internet]. Geneva: WHO Document Production Services (Switzerland); 2010 [cited 2022 Feb 10]. Available from: https://www.who.int/publications/i/item/9789241500852
  19. Korea Centers for Disease Control & Prevention (KCDC). Korean national health and nutrition examination survey (KNHA NES VII-2) [Internet]. Osong: KCDC; 2021 [cited 2022 Apr 11]. Available from: https://knhanes.kdca.go.kr/knhanes/sub03/sub03_02_05.do
  20. Jeong IS, Kang CM. Level of and related factors to diabetes awareness among diabetic adults by gender: based on data from the Korean National Health and Nutrition Examination Survey. Asian Nursing Research. 2021;15(2):129-135. https://doi.org/10.1016/j.anr.2021.01.003
  21. American Diabetes Association. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes-2018. Diabetes Care. 2018;41(Supplement 1):S13-S27. https://doi.org/10.2337/dc18-S002
  22. Korea Centers for Disease Control & Prevention (KCDC). Standardization for eye survey in Korea national health and nutrition examination survey (2017) [Internet]. Osong: KCDC; 2021 [cited 2022 Apr 11]. Available from: https://www.prism.go.kr/homepage/entire/researchDetail.do
  23. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome: An American heart association/national heart, lung, and blood institute scientific statement. Circulation. 2005; 112(17):2735-2752. https://doi.org/10.1161/CIRCULATIONAHA.105.169404
  24. Hong SB, Shin KA. Significance of non HDL-cholesterol and triglyceride to HDL-cholesterol ratio as predictors for metabolic syndrome among Korean elderly. The Korean Journal of Clinical Laboratory Science. 2018;50:245-252. https://doi.org/10.15324/kjcls.2018.50.3.245.
  25. Dean AG, Sullivan KM, Soe MM. OpenEpi: Open Source Epidemiologic Statistics for Public Health, Version. 2013 [Internet]. 2013 Apr 6 [cited 2022 Jan 28]. Available from: http://www.openepi.com
  26. Kim JH. Multicollinearity and misleading statistical results. Korean Journal of Anesthesiology. 2019;72(6):558-569. https://doi.org/10.4097/kja.19087
  27. Lee WJ, Sobrin L, Lee MJ, Kang MH, Seong M, Cho H. The relationship between diabetic retinopathy and diabetic nephropathy in a population-based study in Korea (KNHANES V-2, 3). Investigative Ophthalmology & Visual Science. 2014;55:6547-6553. https://doi.org/10.1167/iovs.14-15001
  28. Klein R. The epidemiology of diabetic retinopathy: findings from the Wisconsin epidemiologic study of diabetic retinopathy. International Ophthalmology Clinics. 1987;27(4):230-238. https://doi.org/10.1097/00004397-198702740-00003
  29. Jamali S, Abrishami M, Lashay A, Ashrafi E, Adibi H, Ghaderi E, et al. Comparison of portable cameras for diabetic retinopathy community screening. Journal of Diabetes Science and Technology. 2021;15(1):201-202. https://doi.org/10.1177/1932296820929357
  30. Jingi AM, Tankeu AT, Ateba NA, Noubiap JJ. Mechanism of worsening diabetic retinopathy with rapid lowering of blood glucose: The synergistic hypothesis. BMC Endocrine Disorders. 2017;17(1):63. https://doi.org/10.1186/s12902-017-0213-3
  31. Sabanayagam C, Banu R, Chee ML, Lee R, Wang YX, Tan G, et al. Incidence and progression of diabetic retinopathy: a systematic review. The Lancet Diabetes & Endocrinology. 2019;7 (2):140-149. https://doi.org/10.1016/S2213-8587(18)30128-1
  32. Raman R, Ganesan S, Pal SS, Gella L, Kulothungan V, Sharma T. Incidence and progression of diabetic retinopathy in urban India: Sankara Nethralaya-Diabetic Retinopathy Epidemiology and Molecular Genetics Study(SN-DREAMS II), Report 1. Ophthalmic Epidemiology. 2017;24(5):294-302. https://doi.org/10.1080/09286586.2017.1290257
  33. Varma R, Choudhury F, Klein R, Chung J, Torres M, Azen SP. Four-year incidence and progression of diabetic retinopathy and macular edema: The Los Angeles Latino eye study. American Journal of Ophthalmology. 2010;149(5):752-761.e1-e3. https://doi.org/10.1016/j.ajo.2009.11.014
  34. Xu J, Xu L, Wang YX, You QS, Jonas JB, Wei WB. Ten-year cumulative incidence of diabetic retinopathy. The Beijing eye study 2001/2011. PLoS One. 2014;9(10):e111320. https://doi.org/10.1371/journal.pone.0111320
  35. Jin P, Peng J, Zou H, Wang W, Fu J, Shen B, et al. The 5-year onset and regression of diabetic retinopathy in Chinese type 2 diabetes patients. PLoS One. 2014;9(11):e113359. https://doi.org/10.1371/journal.pone.0113359
  36. Matthews DR, Stratton IM, Aldington SJ, Holman RR, Kohner EM, UK Prospective Diabetes Study Group. Risks of progression of retinopathy and vision loss related to tight blood pressure control in type 2 diabetes mellitus: UKPDS 69. Archives of Ophthalmology. 2004;122(11):1631-1640. https://doi.org/10.1001/archopht.122.11.1631