Ps-c15-10: association of body mass index, waist-to-height ratio and duration of type 2 diabetes mellitus with diabetic retinopathy in women

Objective: Diabetic retinopathy (DR) is a common microvascular complication of diabetes mellitus (DM). It is a leading cause of visual impairment and blindness worldwide, reducing the quality of life of patients. Clear evidence of association between anthropometric measurements and DR risk is lacking in Nigerian females with type 2 DM (T2DM). Design and Methods: A cross-sectional study of 57 female participants with physician-diagnosed T2DM with or without systemic hypertension. Anthropometric measurements were taken. Fasting blood samples were drawn for laboratory analysis. All patients underwent dilated fundoscopy by a single Ophthalmologist and diabetic retinopathy was graded based on the worse eye. Results: The mean age of the participants was 60.8 ± 11.0 years with no significant age difference between the DR and Non-DR groups. Of the 57 participants, 36 had varying degrees of DR while 21 had no features of DR. Among the patients with DR, 26 were hypertensive diabetic while 10 were only diabetic. The hypertensive diabetic were older than the diabetic. The mean weight and body mass index (BMI) were higher in the non-DR group compared to the DR group. The DR group had significantly longer disease duration for both diabetes and hypertension. The hypertensive diabetic had significantly higher systolic blood pressure (SBP), pulse pressure (PP), total cholesterol-high density lipid ratio (TC:HDL) and serum triglyceride (TG) than the diabetic. BMI was negatively correlated with presence of DR, while weight, TyG-BMI, weight-height ratio (WHt), hip circumference (HC) and DM duration were positively correlated. BMI, WHt and TyG-BMI were negatively correlated with severity of DR while DM duration showed positive correlation. Linear regression showed that the independent determinant of the presence of DR in hypertensive diabetic were WHt and DM duration, while for severity of DR, DM duration, neutrophil-lymphocyte ratio (NLR) and HbA1c status were predictors. When adjusted for DM duration, presence of DR was predicted by WHt while severity was predicted by BMI. The curve of the receiver operating characteristic was also plotted to establish the relevance of each of the factors predicting DR and their area under the curve (AUC) was compared. The results showed that DM duration, HbA1c status, NLR, HTN duration, BMI, WHt were predictors. Conclusions: BMI, waist-to-height ratio and DM duration and neutrophil-to-lymphocyte ratio are associated with the occurrence and severity of DR in female hypertensive diabetic.