Fig. 1Study participants.
Fig. 2Odds ratio of diabetic retinopathy based on various demographic, lifestyle, social, and clinical factors. NPDR, non-proliferative diabetic retinopathy; PDR, proliferative diabetic retinopathy; DM, diabetes mellitus; CI, confidence interval.
Fig. 3Odds ratio of macular edema based on various demographic, lifestyle, social, and clinical factors. CI, confidence interval.
Table 1Comparison of characteristics with DR status
Variable |
Without DR |
NPDR |
PDR |
P value |
Number |
59 (32.2) |
72 (39.3) |
52 (28.4) |
|
Sex |
|
|
|
0.301 |
Male |
27 (45.8) |
41 (56.9) |
23 (44.2) |
Female |
32 (54.2) |
31 (43.1) |
29 (55.8) |
Age, yr |
70±11 |
66±12.25 |
62±17 |
0.001 |
Duration of DM, yr |
20±6 |
22±7 |
23.5±9 |
0.022 |
Body mass index, kg/m2
|
24.66±3.12 |
24.7±3.26 |
24.21±3.45 |
0.694 |
Body weight, kg |
63.4±12.45 |
64.36±10.67 |
62.52±10.28 |
0.606 |
Systolic blood pressure, mm Hg |
127.9±15.98 |
127.99±14.26 |
124.46±13.92 |
0.332 |
Glycosylated hemoglobin, % |
7.7±2 |
8±2.1 |
8.05±2.1 |
0.097 |
Fasting plasma glucose, mg/dL |
134±59.5 |
158±69.5 |
151.5±80.25 |
0.060 |
LDL-C, mg/dL |
102±37 |
95±37.5 |
85±42.5 |
0.139 |
Urine microalbumin, µg/mg Cr |
7.9±14.8 |
12.55±33.55 |
48.2±302.6 |
<0.001 |
Serum creatinine, mg/dL |
0.7±0.4 |
0.8±0.4 |
0.85±0.5 |
0.017 |
Creatinine clearance, mL/min |
101.4±42.75 |
90±40.62 |
83.6±49.12 |
0.044 |
Alanine transaminase, U/L |
18±10.5 |
18±10.25 |
16±8 |
0.063 |
γ-Glutamyltransferase, U/L |
24±21 |
27±18.25 |
18±13 |
0.001 |
Physical activity and habits |
|
|
|
0.263 |
Alcohol use |
|
|
|
Never |
34 (57.6) |
36 (50) |
35 (67.3) |
Former |
5 (8.5) |
12 (16.7) |
6 (11.5) |
Current |
20 (33.9) |
24 (33.3) |
11 (21.2) |
Smoking status |
|
|
|
0.089 |
Never |
35 (59.3) |
40 (55.6) |
33 (63.5) |
Former |
19 (32.2) |
16 (22.2) |
8 (15.4) |
Current |
5 (8.5) |
16 (22.2) |
11 (21.2) |
Daily activity within a year |
|
|
|
0.041 |
Nearly bed-ridden |
0 |
3 (4.2) |
6 (11.5) |
Light |
28 (47.5) |
39 (54.2) |
29 (55.8) |
Moderate |
29 (49.2) |
24 (33.3) |
15 (28.8) |
Heavy |
2 (3.4) |
6 (8.3) |
2 (3.8) |
Regular exercise, times/week |
3±6.5 |
3±5 |
0±5 |
0.021 |
Family history DM |
35 (60.3) |
49 (72.1) |
41 (78.8) |
0.107 |
Hypertension |
27 (50.9) |
24 (43.6) |
25 (53.2) |
0.654 |
Dyslipidemia |
4 (9.8) |
3 (6.5) |
3 (8.8) |
0.844 |
Obesity |
12 (20.3) |
19 (27.1) |
13 (25) |
0.689 |
Cardiovascular disease |
1 (1.8) |
2 (2.8) |
6 (12) |
0.050 |
Stroke |
13 (23.2) |
7 (9.7) |
6 (12) |
0.096 |
Cancer |
21 (36.2) |
16 (22.5) |
8 (15.7) |
0.045 |
Table 2Comparison of the underlying comorbidities and the use of medications with a grade of DR
Variable |
Without DR |
NPDR |
PDR |
P value |
Hypertension |
44 (74.6) |
63 (87.5) |
43 (82.7) |
0.188 |
Dyslipidemia |
42 (71.2) |
56 (77.8) |
28 (53.8) |
0.018 |
Myocardial infarction |
0 |
1 (1.4) |
0 |
1.000 |
Angina |
5 (8.5) |
10 (13.9) |
6 (11.5) |
0.672 |
Heart failure |
0 |
2 (2.8) |
2 (3.8) |
0.386 |
Stroke (hemorrhage) |
1 (1.7) |
1 (1.4) |
1 (1.9) |
1.000 |
Stroke (infarction) |
9 (15.3) |
9 (12.5) |
7 (13.5) |
0.962 |
Peripheral arterial disease |
3 (5.1) |
7 (9.7) |
6 (11.5) |
0.482 |
Hospitalization within past year |
11 (18.6) |
18 (25) |
20 (38.5) |
0.057 |
Operation within past year |
7 (11.9) |
10 (13.9) |
11 (21.2) |
0.366 |
Microvascular complication |
|
|
|
|
Microalbuminuria |
18 (30.5) |
26 (36.1) |
35 (67.3) |
<0.001 |
Overt proteinuria |
6 (10.2) |
13 (18.1) |
19 (36.5) |
0.003 |
Chronic kidney disease |
11 (18.6) |
9 (12.5) |
15 (28.8) |
0.076 |
Peripheral neuropathy |
27 (45.8) |
36 (50) |
25 (49.0) |
0.896 |
Autonomic neuropathy |
14 (24.1) |
20 (29.9) |
22 (46.8) |
0.043 |
Medications |
|
|
|
|
Metformin |
39 (66.1) |
50 (69.4) |
36 (69.2) |
0.920 |
Sulfonylurea |
41 (69.5) |
40 (55.6) |
26 (50) |
0.089 |
Dipeptidyl peptidase-4 inhibitor |
24 (40.7) |
19 (26.4) |
12 (23.1) |
0.096 |
Meglitinide |
1 (1.7) |
3 (4.2) |
4 (7.7) |
0.305 |
Thiazolidinedione |
2 (3.4) |
2 (2.8) |
3 (5.8) |
0.715 |
α-Glucosidase inhibitor |
0 |
1 (1.4) |
1 (1.9) |
0.745 |
SGLT-2 inhibitor |
0 |
0 |
0 |
- |
GLP-1 agonist |
0 |
0 |
0 |
- |
Rapid-acting insulin |
1 (1.7) |
13 (18.1) |
13 (25) |
<0.001 |
Long-acting insulin |
12 (20.3) |
28 (38.9) |
26 (50) |
0.004 |
Premixed insulin |
12 (20.3) |
14 (19.4) |
12 (23.1) |
0.872 |
Angiotensin II receptor blocker |
30 (50.8) |
37 (51.4) |
23 (44.2) |
0.709 |
ACEi |
3 (5.1) |
7 (9.7) |
7 (13.5) |
0.325 |
Calcium channel blockers |
24 (40.7) |
22 (30.6) |
19 (36.5) |
0.471 |
Diuretics |
8 (13.6) |
8 (11.1) |
6 (11.5) |
0.920 |
β-Blockers |
2 (3.4) |
10 (13.9) |
10 (19.2) |
0.024 |
Statin |
28 (47.5) |
46 (63.9) |
27 (51.9) |
0.147 |
Aspirin |
13 (22.0) |
1 (1.4) |
11 (21.2) |
0.947 |
Clopidogrel |
10 (16.9) |
14 (19.4) |
4 (7.7) |
0.167 |
Cilostazol |
28 (47.5) |
28 (38.9) |
13 (25) |
0.051 |
Table 3Comparison of characteristics with ME status
Variable |
Without ME |
With ME |
P value |
Number |
136 |
46 |
|
Sex |
|
|
0.027 |
Male |
74 (54.4) |
16 (34.8) |
|
Female |
62 (45.6) |
30 (65.2) |
|
Age, yr |
66.5±12 |
63.5±15.5 |
0.049 |
Duration of DM, yr |
21±7.5 |
23.5±7 |
0.037 |
Body mass index, kg/m2
|
24.6±3.95 |
23.95±4.83 |
0.412 |
Body weight, kg |
64.76±10.27 |
60.6±8.93 |
0.015 |
Systolic blood pressure, mm Hg |
127.96±14.75 |
124.63±14.09 |
0.182 |
Glycosylated hemoglobin, % |
7.75±1.82 |
8.25±2.35 |
0.029 |
Fasting plasma glucose, mg/dL |
145.5±68.75 |
166±73.5 |
0.590 |
LDL-C, mg/dL |
97±38.5 |
96.5±40.25 |
0.561 |
Urine microalbumin, µg/mg Cr |
11.45±27.55 |
32.45±210.03 |
0.001 |
Serum creatinine, mg/dL |
0.8±0.4 |
0.8±0.38 |
0.477 |
Creatinine clearance, mL/min |
93.91±38.09 |
84±34.9 |
0.121 |
Alanine transaminase, U/L |
18±12 |
14±5 |
<0.001 |
γ-Glutamyltransferase, U/L |
26±19 |
19±12 |
0.001 |
Physical activity and habits |
|
|
|
Alcohol use |
|
|
0.066 |
Never |
72 (52.9) |
33 (71.7) |
Former |
18 (13.2) |
5 (10.9) |
Current |
46 (33.8) |
8 (17.4) |
Smoking status |
|
|
0.538 |
Never |
78 (57.4) |
30 (65.2) |
Former |
34 (25) |
8 (17.4) |
Current |
24 (17.6) |
8 (17.4) |
Daily activity within a year |
|
|
0.056 |
Nearly bed-ridden |
6 (4.4) |
3 (6.5) |
Light |
65 (47.8) |
30 (65.2) |
Moderate |
55 (40.4) |
13 (28.3) |
Heavy |
10 (7.4) |
0 |
|
Regular exercise, times/week |
3±5.5 |
1.5±5 |
0.171 |
Family history |
|
|
|
DM |
90 (68) |
34 (75.6) |
0.451 |
Hypertension |
51 (44.7) |
24 (60) |
0.103 |
Dyslipidemia |
8 (8.4) |
2 (7.7) |
1.000 |
Obesity |
28 (20.9) |
16 (34.8) |
0.074 |
Cardiovascular disease |
2 (1.5) |
7 (15.9) |
0.001 |
Stroke |
21 (15.8) |
4 (9.1) |
0.327 |
Cancer |
34 (25.2) |
11 (25) |
1.000 |
Table 4Comparison of the underlying comorbidities and medication use with the presence of ME
Variable |
Without ME |
With ME |
P value |
Hypertension |
111 (81.6) |
38 (82.6) |
1.000 |
Dyslipidemia |
96 (70.6) |
29 (63.0) |
0.362 |
Myocardial infarction |
1 (0.7) |
0 |
1.000 |
Angina |
13 (9.6) |
7 (15.2) |
0.286 |
Heart failure |
2 (1.5) |
2 (4.3) |
0.265 |
Stroke (hemorrhage) |
3 (2.2) |
0 |
0.573 |
Stroke (infarction) |
20 (14.7) |
5 (10.9) |
0.573 |
Peripheral arterial disease |
10 (7.4) |
5 (10.9) |
0.535 |
Hospitalization within past year |
31 (22.8) |
18 (39.1) |
0.036 |
Operation within past year |
14 (10.3) |
14 (30.4) |
0.002 |
Microvascular complication |
|
|
|
Retinopathy |
69 (50.7) |
42 (91.3) |
<0.001 |
Microalbuminuria |
53 (39.0) |
26 (56.5) |
0.041 |
Overt proteinuria |
23 (16.9) |
15 (32.6) |
0.035 |
Chronic kidney disease |
25 (18.4) |
10 (21.7) |
0.666 |
Peripheral neuropathy |
61 (44.9) |
27 (60) |
0.087 |
Autonomic neuropathy |
38 (29.5) |
18 (42.9) |
0.131 |
Medications |
|
|
|
Metformin |
94 (69.1) |
30 (65.2) |
0.715 |
Sulfonylurea |
84 (61.8) |
22 (47.8) |
0.120 |
Dipeptidyl peptidase-4 inhibitor |
43 (31.6) |
11 (23.9) |
0.356 |
Meglitinide |
4 (2.9) |
4 (8.7) |
0.113 |
Thiazolidinedione |
4 (2.9) |
3 (6.5) |
0.371 |
α-Glucosidase inhibitor |
2 (1.5) |
0 |
1.000 |
SGLT-2 inhibitor |
0 |
0 |
- |
GLP-1 agonist |
0 |
0 |
- |
Rapid-acting insulin |
15 (11.0) |
12 (26.1) |
0.017 |
Long-acting insulin |
47 (34.6) |
19 (41.3) |
0.479 |
Premixed insulin |
28 (20.6) |
10 (21.7) |
0.837 |
Angiotensin II receptor blocker |
70 (51.5) |
19 (41.3) |
0.306 |
ACEi |
10 (7.4) |
7 (15.2) |
0.142 |
Calcium channel blockers |
49 (36.0) |
16 (34.8) |
1.000 |
Diuretics |
17 (12.5) |
5 (10.9) |
1.000 |
β-Blockers |
17 (12.5) |
5 (10.9) |
1.000 |
Statin |
72 (52.9) |
28 (60.9) |
0.394 |
Aspirin |
31 (22.8) |
7 (15.2) |
0.304 |
Clopidogrel |
22 (16.2) |
5 (10.9) |
0.477 |
Cilostazol |
55 (40.4) |
14 (30.4) |
0.292 |