J Korean Med Sci.  2011 Aug;26(8):1068-1073. 10.3346/jkms.2011.26.8.1068.

Prevalence and Associated Factors of Diabetic Retinopathy in Rural Korea: The Chungju Metabolic Disease Cohort Study

Affiliations
  • 1Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. hys@catholic.ac.kr
  • 2Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 3Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 4The Catholic Institute of Ubiquitous Healthcare, Seoul, Korea.

Abstract

This study was aimed to investigate the prevalence of diabetic retinopathy and its associated factors in rural Korean patients with type 2 diabetes. A population-based, cross-sectional diabetic retinopathy survey was conducted from 2005 to 2006 in 1,298 eligible participants aged over 40 yr with type 2 diabetes identified in a rural area of Chungju, Korea. Diabetic retinopathy was diagnosed by a practicing ophthalmologist using funduscopy. The overall prevalence of diabetic retinopathy in the population was 18% and proliferative or severe non-proliferative form was found in 5.0% of the study subjects. The prevalence of retinopathy was 6.2% among those with newly diagnosed type 2 diabetes and 2.4% of them had a proliferative or severe non-proliferative diabetic retinopathy. The odds ratio of diabetic retinopathy increased with the duration of diabetes mellitus (5-10 yr: 5.2- fold; > 10 yr: 10-fold), postprandial glucose levels (> 180 mg/dL: 2.5-fold), and HbA1c levels (every 1% elevation: 1.34-fold). The overall prevalence of diabetic retinopathy in rural Korean patients was similar to or less than that of other Asian group studies. However, the number of patients with proliferative or severe non-proliferative diabetic retinopathy was still high and identified more frequently at the time of diagnosis. This emphasizes that regular screening for diabetic retinopathy and more aggressive management of glycemia can reduce the number of people who develop diabetic retinopathy.

Keyword

Diabetic Retinopathy; Prevalence; Risk Factors

MeSH Terms

Aged
Blood Glucose/analysis
Cohort Studies
Diabetes Mellitus, Type 2/complications
Diabetic Retinopathy/complications/*epidemiology/ethnology
Female
Hemoglobin A, Glycosylated/analysis
Humans
Male
Middle Aged
Odds Ratio
Prevalence
Republic of Korea/epidemiology
Risk Factors
Rural Population

Cited by  1 articles

Risk Factor Analysis of Diabetic Retinopathy Diagnosed with Non-mydriatic Fundus Camera: KNHANES V
Jung Suk Yoon, Seung-Kook Baek, Young Hoon Lee
J Korean Ophthalmol Soc. 2019;60(6):555-568.    doi: 10.3341/jkos.2019.60.6.555.


Reference

1. King H, Aubert RE, Herman WH. Global burden of diabetes, 1995-2025: prevalence, numerical estimates, and projections. Diabetes Care. 1998. 21:1414–1431.
2. Chan JC, Malik V, Jia W, Kadowaki T, Yajnik CS, Yoon KH, Hu FB. Diabetes in Asia: epidemiology, risk factors, and pathophysiology. JAMA. 2009. 301:2129–2140.
3. Yoon KH, Lee JH, Kim JW, Cho JH, Choi YH, Ko SH, Zimmet P, Son HY. Epidemic obesity and type 2 diabetes in Asia. Lancet. 2006. 368:1681–1688.
4. Porta M, Bandello F. Diabetic retinopathy: a clinical update. Diabetologia. 2002. 45:1617–1634.
5. Klein R, Klein BE, Moss SE, Davis MD, DeMets DL. The Wisconsin Epidemiologic Study of Diabetic Retinopathy. III: prevalence and risk of diabetic retinopathy when age at diagnosis is 30 or more years. Arch Ophthalmol. 1984. 102:527–532.
6. Harris MI, Klein R, Welborn TA, Knuiman MW. Onset of NIDDM occurs at least 4-7 yr before clinical diagnosis. Diabetes Care. 1992. 15:815–819.
7. UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998. 352:837–853.
8. Looker HC, Krakoff J, Knowler WC, Bennett PH, Klein R, Hanson RL. Longitudinal studies of incidence and progression of diabetic retinopathy assessed by retinal photography in pima indians. Diabetes Care. 2003. 26:320–326.
9. Leske MC, Wu SY, Hennis A, Nemesure B, Hyman L, Schachat A. Incidence of diabetic retinopathy in the Barbados Eye Studies. Ophthalmology. 2003. 110:941–947.
10. McCarty DJ, Fu CL, Harper CA, Taylor HR, McCarty CA. Five-year incidence of diabetic retinopathy in the Melbourne visual impairment project. Clin Experiment Ophthalmol. 2003. 31:397–402.
11. van Leiden HA, Dekker JM, Moll AC, Nijpels G, Heine RJ, Bouter LM, Stehouwer CD, Polak BC. Risk factors for incident retinopathy in a diabetic and nondiabetic population: the Hoorn study. Arch Ophthalmol. 2003. 121:245–251.
12. Kwon HS, Park YM, Lee HJ, Lee JH, Choi YH, Ko SH, Lee JM, Kim SR, Kang SY, Lee WC, Ahn MS, Noh JH, Kang JM, Kim DS, Yoon KH, Cha BY, Lee KW, Kang SK, Son HY. Prevalence and clinical characteristics of the metabolic syndrome in middle-aged Korean adults. Korean J Intern Med. 2005. 20:310–316.
13. World Medical Association. Declaration of Helsinki. Ethical Principles for Medical Research Involving Human Subjects. 2000. Edinburgh: 52nd WMA General Assembly.
14. World Health Organization. Definition, diagnosis and classification of diabetes mellitus and its complications part 1: diagnosis and classification of diabetes mellitus. 1999. World Health Organization.
15. Chalmers J, MacMahon S, Mancia G, Whitworth J, Beilin L, Hansson L, Neal B, Rodgers A, Ni Mhurchu C, Clark T. 1999 World Health Organization-International Society of Hypertension Guidelines for the management of hypertension. Guidelines sub-committee of the World Health Organization. Clin Exp Hypertens. 1999. 21:1009–1060.
16. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972. 18:499–502.
17. Wilkinson CP, Ferris FL 3rd, Klein RE, Lee PP, Agardh CD, Davis M, Dills D, Kampik A, Pararajasegaram R, Verdaguer JT. Global Diabetic Retinopathy Project Group. Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales. Ophthalmology. 2003. 110:1677–1682.
18. Lee HC, Yang JY, Lim SK, Hong CS, Huh KB, Lee SY. A prospective study of diabetic complications. J Korean Diabetes Assoc. 1984. 8:47–53.
19. Nam JH, Lee SH, Lee HJ, Han JH, Ha SW, Kim BW. The prevalence of chronic complications in non-insulin dependent diabetic patients. J Korean Diabetes Assoc. 1999. 23:702–714.
20. Park JY, Kim SW, Cho GY, Lee MH, Je SJ, Lee KU, Kim GS. The prevalence of micro- and macrovascular complications of Korean NIDDM patients. J Korean Diabetes Assoc. 1993. 17:377–385.
21. Lim S, Kim DJ, Jeong IK, Son HS, Chung CH, Koh G, Lee DH, Won KC, Park JH, Park TS, Ahn J, Kim J, Park KG, Ko SH, Ahn YB, Lee I. A nationwide survey about the current status of glycemic control and complications in diabetic patients in 2006: The Committee of the Korean Diabetes Association on the Epidemiology of Diabetes Mellitus. Korean Diabetes J. 2009. 33:48–57.
22. Chang C, Lu F, Yang YC, Wu JS, Wu TJ, Chen MS, Chuang LM, Tai TY. Epidemiologic study of type 2 diabetes in Taiwan. Diabetes Res Clin Pract. 2000. 50:Suppl 2. S49–S59.
23. Liu DP, Molyneaux L, Chua E, Wang YZ, Wu CR, Jing H, Hu LN, Liu YJ, Xu ZR, Yue DK. Retinopathy in a Chinese population with type 2 diabetes: factors affecting the presence of this complication at diagnosis of diabetes. Diabetes Res Clin Pract. 2002. 56:125–131.
24. Rema M, Premkumar S, Anitha B, Deepa R, Pradeepa R, Mohan V. Prevalence of diabetic retinopathy in urban India: the Chennai Urban Rural Epidemiology Study (CURES) eye study, I. Invest Ophthalmol Vis Sci. 2005. 46:2328–2333.
25. Rani PK, Raman R, Chandrakantan A, Pal SS, Perumal GM, Sharma T. Risk factors for diabetic retinopathy in self-reported rural population with diabetes. J Postgrad Med. 2009. 55:92–96.
26. Cugati S, Kifley A, Mitchell P, Wang JJ. Temporal trends in the age-specific prevalence of diabetes and diabetic retinopathy in older persons: population-based survey findings. Diabetes Res Clin Pract. 2006. 74:301–308.
27. Tapp RJ, Shaw JE, Harper CA, de Courten MP, Balkau B, McCarty DJ, Taylor HR, Welborn TA, Zimmet PZ. AusDiab Study Group. The prevalence of and factors associated with diabetic retinopathy in the Australian population. Diabetes Care. 2003. 26:1731–1737.
28. Hu YH, Pan XR, Liu PA, Li GW, Howard BV, Bennett PH. Coronary heart disease and diabetic retinopathy in newly diagnosed diabetes in Da Qing, China: the Da Qing IGT and Diabetes Study. Acta Diabetol. 1991. 28:169–173.
29. Wang WQ, Ip TP, Lam KS. Changing prevalence of retinopathy in newly diagnosed non-insulin dependent diabetes mellitus patients in Hong Kong. Diabetes Res Clin Pract. 1998. 39:185–191.
30. Agarwal S, Raman R, Kumari RP, Deshmukh H, Paul PG, Gnanamoorthy P, Kumaramanickavel G, Sharma T. Diabetic retinopathy in type II diabetics detected by targeted screening versus newly diagnosed in general practice. Ann Acad Med Singapore. 2006. 35:531–535.
Full Text Links
  • JKMS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr