Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Oct;98(43):e17693.
doi: 10.1097/MD.0000000000017693.

Relationship between anemia, serum bilirubin concentrations, and diabetic retinopathy in individuals with type 2 diabetes

Jin Ook Chung  1 , Seon-Young Park  2 , Dong Jin Chung  1 , Min Young Chung  1
Affiliations

Relationship between anemia, serum bilirubin concentrations, and diabetic retinopathy in individuals with type 2 diabetes

Jin Ook Chung et al. Medicine (Baltimore). 2019 Oct.

Abstract

This study sought to assess the hypothesis that anemia is associated with diabetic retinopathy in type 2 diabetes mellitus (DM) and investigate the factors mediating the relationship between anemia and diabetic retinopathy.In total, 1637 individuals with type 2 DM were examined in a cross-sectional study. Anemia was defined as hemoglobin level <120 g/L in women and <130 g/L in men. A logistic regression model was used to determine the association between anemia and diabetic retinopathy.Anemia was more prevalent in individuals with diabetic retinopathy. Logistic regression analysis found a statistically significant association between anemia and diabetic retinopathy after adjustment for traditional risk factors (odds ratio, 1.44; 95% confidence interval, 1.10-1.89, P = .009). Further adjustment for serum bilirubin levels removed the statistically significant association.In individuals with type 2 DM, anemia is related to diabetic retinopathy, and its association may be mediated by a correlated change in serum bilirubin levels.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Diabetic retinopathy prevalence according to anemia grade. Diabetic retinopathy severity increased with anemia grade (P < .001). Data are represented as frequencies (percentages). NPDR = non-proliferative diabetic retinopathy, PDR = proliferative diabetic retinopathy
Figure 2
Figure 2
Odds ratios for diabetic retinopathy with anemia as an independent variable after adjusting for confounding factors. Odd ratios were adjusted for age, sex, smoking, body mass index, ALT, hypertension, hyperlipidemia, DM duration, A1C level, and nephropathy.
See this image and copyright information in PMC

References

    1. Cheung N, Mitchell P, Wong TY. Diabetic retinopathy. Lancet 2010;376:124–36.. - PubMed
    1. Cheung N, Rogers S, Couper DJ, et al. Is diabetic retinopathy an independent risk factor for ischemic stroke? Stroke 2007;38:398–401.. - PubMed
    1. Thomas MC, MacIsaac RJ, Tsalamandris C, et al. Unrecognized anemia in patients with diabetes: a cross-sectional survey. Diabetes Care 2003;26:1164–9.. - PubMed
    1. Zoppini G, Targher G, Chonchol M, et al. Anaemia, independent of chronic kidney disease, predicts all-cause and cardiovascular mortality in type 2 diabetic patients. Atherosclerosis 2010;210:575–80.. - PubMed
    1. Thomas MC. Anemia in diabetes: marker or mediator of microvascular disease? Nat Clin Pract Nephrol 2007;3:20–30.. - PubMed