1.
Association of non-alcoholic fatty liver disease with diabetic retinopathy in type 2 diabetic patients: A meta-analysis of observational studies.
Song, D, Li, C, Wang, Z, Zhao, Y, Shen, B, Zhao, W
Journal of diabetes investigation. 2021;(8):1471-1479
Abstract
AIMS/INTRODUCTION Non-alcoholic fatty liver disease (NAFLD) is becoming more and more prevalent in type 2 diabetes mellitus. Evidence connecting NAFLD to diabetic retinopathy (DR) is increasing, but the results vary. Thus, we undertook a meta-analysis to explore the effect of NAFLD on diabetic retinopathy in patients with type 2 diabetes mellitus. MATERIALS AND METHODS PubMed, Embase, Cochrane and Scopus database were searched for until September 30, 2019. Original studies analyzing the association between NAFLD and diabetic retinopathy in the type 2 diabetic population were included. This meta-analysis was processed by RevMan 5.3 software. Subgroup analyses based on countries were carried out. The pooled odds ratios and 95% confidence intervals were used to evaluate the association between NAFLD and diabetic retinopathy incidence. The I2 test was used to assess heterogeneity of studies. RESULTS We retrieved 414 articles, and nine studies involving 7,170 patients were included in the final analysis. The pooled effects estimate suggested that NAFLD was not associated with the risk of diabetic retinopathy in patients with type 2 diabetes mellitus. Subgroup analysis suggested that in China, Korea and Iran, patients with type 2 diabetes mellitus with NAFLD had a decreased risk for diabetic retinopathy compared with the non-NAFLD individuals. However, in Italy and India, patients with type 2 diabetes mellitus with NAFLD had an increased risk for diabetic retinopathy compared with the non-NAFLD individuals. In addition, no relevance between NAFLD and diabetic retinopathy was found in America. CONCLUSIONS On the whole, there was no association between NAFLD and diabetic retinopathy in individuals with type 2 diabetes mellitus. However, subgroup analysis showed that a difference of country may have an influence on the result.
2.
Is central obesity associated with diabetic retinopathy in Chinese individuals? An exploratory study.
Zhou, JB, Yuan, J, Tang, XY, Zhao, W, Luo, FQ, Bai, L, Li, B, Cong, J, Qi, L, Yang, JK
The Journal of international medical research. 2019;(11):5601-5612
Abstract
OBJECTIVE To our knowledge, the independent association between central obesity, defined by waist circumference (WC) or waist-to-hip ratio (WHR), and diabetic retinopathy (DR) remains unknown in Chinese individuals. METHOD The study was conducted in two stages. First, the relationship between WC or WHR and DR was estimated in a case-control set (DR vs. non-DR) for the whole population before and after propensity score matching. Subsequently, a systematic review and meta-analysis was performed on evidence from the literature to validate the relationship. RESULTS Of 511 eligible patients, DR (N = 156) and non-DR (N = 156) patients with similar propensity scores were included in the propensity score matching analyses. Central obesity (defined by WC) was associated with risk of DR (odds ratio [OR] 1.07, 95% confidence interval [95% CI] (1.03–1.10). The meta-analysis showed that central obesity significantly increased the risk of DR by 12% (OR 1.12, 95% CI 1.02–1.22). Analysis of data from 18 studies showed a significant association between continuous body mass index and risk of proliferative DR (OR 0.95, 95% CI 0.93–0.98; I2 = 50%). CONCLUSION Central obesity, particularly as defined by WC, is associated with the risk of DR in the Chinese population.