Purpose: To investigate the associations between body mass index (BMI) with diabetes mellitus (DM) and vision-threatening diabetic retinopathy (VTDR).
Methods: This was a longitudinal study which included DM-free participants aged ≥40 years from the Lingtou Eye Cohort Study at baseline (2008-2010). Physical and ocular examinations were performed at baseline and annual follow-ups under standardised protocol. Two 45° non-mydriatic colour digital retinal photographs were obtained for each eye at all study visits, and presence of VTDR at the 2016 follow-up was graded by a deep-learning algorithm (LableMe) with proved high accuracy for detection of VTDR.
Results: A total of 2934 participants were included with a mean (SD) age of 59.5 (7.3) years (58.3% men). Participants with incident DM (441/2934, 15%) were significantly older (p<0.001), had higher obesity levels (p<0.001), higher systolic blood pressure (SBP) (p<0.001), diastolic blood pressure (p<0.001), fasting plasma glucose (FPG) (p<0.001), triglycerides (p=0.002) and high-density lipoprotein cholesterol (p<0.001), as compared with those without. Participants with incident VTDR (48/2934, 1.63%) were also older (p<0.001), had higher SBP (p=0.013) and FPG (p<0.001), but did not differ in baseline BMI, comparing with those without. Regression analysis showed that higher baseline BMI was significantly related to incident DM (p<0.005), but not incident VTDR, during the follow-up. Subgroup analysis among participants with incident DM also revealed no association between BMI and VTDR.
Conclusions: Higher baseline BMI increased the risk of incident DM, but was not related to the risk of VTDR in this adult Chinese population.
Keywords: epidemiology.
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