Diabetic retinopathy in African Americans with type 1 diabetes: The New Jersey 725: II. Risk factors

Abstract

Objective: To determine whether diabetic retinopathy in African Americans with type 1 diabetes is associated with the following 6 putative risk factors: duration of diabetes, glycemic control, systemic hypertension, renal disease, socioeconomic status, and male sex.

Methods: Patients in The New Jersey 725 study underwent detailed ocular evaluation, a structured clinical interview, blood pressure measurements, and assays of blood and urine samples.

Results: Glycemic control was poor; 89.8% of the patients had glycosylated hemoglobin values of more than 0.08. Renal disease and systemic hypertension were present in 49.8% and 34.3% of patients, respectively. Frequency and severity of retinopathy were significantly associated with longer duration of diabetes (P<.001). After adjusting for duration of diabetes and other confounding variables, on average, patients with total glycosylated hemoglobin values in the highest quartile were 3 times more likely to have any retinopathy than those in the lowest quartile; patients with renal disease, 3 times more likely to have any retinopathy and 10 times more likely to have proliferative retinopathy than patients without renal disease; and patients in the highest quartile of systolic sitting blood pressure, 3 times more likely to have proliferative retinopathy than patients in the lowest quartile.

Conclusions: Risk factors for diabetic retinopathy in African Americans with type 1 diabetes include presence of renal disease, poor glycemic control, high systolic blood pressure, and long duration of diabetes.