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Horm Metab Res 2021; 53(12): 801-809
DOI: 10.1055/a-1678-7092
Endocrine Care

Association Between Prediabetes and Retinopathy: A Meta-Analysis

Ji Jin
1   Department of Ophthalmology, The Second Affiliated Hospital of Soochow University, Suzhou, China
,
Peirong Lu 
2   Department of Ophthalmology, The First Affiliated Hospital of Soochow University, Suzhou, China
› InstitutsangabenGefördert durch: National Natural Science Foundation of China 81671641
Gefördert durch: Suzhou Science and Technology Fund of China No. SYS2020137
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Abstract

Diabetes confers an increased risk of microvascular complications, including retinopathy. However, whether prediabetes is also related to retinopathy has not been comprehensively examined. We performed a meta-analysis to evaluate the relationship between prediabetes and retinopathy. This meta-analysis included relevant observational studies from Medline, Embase, and Web of Science databases. A random-effect model after incorporation of the intra-study heterogeneity was selected to pool the results. Subgroup analyses were applied to evaluate the influences of study characteristics on relationship. Nine cross-sectional studies including 14 751 community dwelling adult participants were included; 3847 (26.1%) of them were prediabetic. Results showed that prediabetes was associated with a higher prevalence of retinopathy compared to normoglycemia [odds ratio (OR): 1.55, 95% confidence interval (CI): 1.10–2.20, p=0.01, I2=34%]. Sensitivity analysis by excluding one study at a time showed consistent result (OR: 1.35 to 1.73, p all<0.05). Subgroup analysis showed study characteristics such as definition of prediabetes, country of study, sample size, mean age of participants, or univariate or multivariate analyses may not significantly affect the association (p for subgroup difference all>0.05). Current evidence suggests that patients with prediabetes may be associated with higher prevalence of retinopathy as compared to those with normoglycemia. Although prospective cohort studies are needed to validate these findings, results of our meta-analysis highlighted the importance of early prevention of retinopathy in patients with prediabetes.

Key words

retinopathy - prediabetes - prevalence - cross-sectional - meta-analysis


Publikationsverlauf

Eingereicht: 29. September 2021

Angenommen nach Revision: 19. Oktober 2021

Artikel online veröffentlicht:
10. Dezember 2021

© 2021. Thieme. All rights reserved.

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  • References

  • 1 Crabtree GS, Chang JS. Management of complications and vision loss from proliferative diabetic retinopathy. Curr Diab Rep 2021; 21: 33
    CrossrefPubMedSuche in Google Scholar
  • 2 Nian S, Lo ACY, Mi Y. et al Neurovascular unit in diabetic retinopathy: pathophysiological roles and potential therapeutical targets. Eye Vis (Lond) 2021; 8: 15
    CrossrefPubMedSuche in Google Scholar
  • 3 Kramer CK, Rodrigues TC, Canani LH. et al Diabetic retinopathy predicts all-cause mortality and cardiovascular events in both type 1 and 2 diabetes: Meta-analysis of observational studies. Diabetes Care 2011; 34: 1238-1244
    CrossrefPubMedSuche in Google Scholar
  • 4 Xu XH, Sun B, Zhong S. et al Diabetic retinopathy predicts cardiovascular mortality in diabetes: A meta-analysis. BMC Cardiovasc Disord 2020; 20: 478
    CrossrefPubMedSuche in Google Scholar
  • 5 Cho NH, Shaw JE, Karuranga S. et al IDF diabetes atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res Clin Pract 2018; 138: 271-281
    CrossrefPubMedSuche in Google Scholar
  • 6 Zheng Y, Ley SH, Hu FB. Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nat Rev Endocrinol 2018; 14: 88-98
    CrossrefPubMedSuche in Google Scholar
  • 7 Tabak AG, Herder C, Rathmann W. et al Prediabetes: A high-risk state for diabetes development. Lancet 2012; 379: 2279-2290
    CrossrefPubMedSuche in Google Scholar
  • 8 Guasch-Ferre M, Hruby A, Toledo E. et al Metabolomics in prediabetes and diabetes: A systematic review and meta-analysis. Diabetes Care 2016; 39: 833-846
    CrossrefPubMedSuche in Google Scholar
  • 9 Rajpal A, Ismail-Beigi F. Intermittent fasting and 'metabolic switch': effects on metabolic syndrome, prediabetes and type 2 diabetes. Diabetes Obes Metab 2020; 22: 1496-1510
    CrossrefPubMedSuche in Google Scholar
  • 10 Sallar A, Dagogo-Jack S. Regression from prediabetes to normal glucose regulation: State of the science. Exp Biol Med (Maywood) 2020; 245: 889-896
    CrossrefPubMedSuche in Google Scholar
  • 11 Hostalek U. Global epidemiology of prediabetes - present and future perspectives. Clin Diabetes Endocrinol 2019; 5: 5
    CrossrefPubMedSuche in Google Scholar
  • 12 Chatterton H, Younger T, Fischer A. et al Risk identification and interventions to prevent type 2 diabetes in adults at high risk: Summary of NICE guidance. BMJ 2012; 345: e4624
    CrossrefPubMedSuche in Google Scholar
  • 13 [Anonymous] Classification and diagnosis of diabetes: standards of medical care in diabetes-2019. Diabetes Care 2019; 42: S13-S28
    CrossrefPubMedSuche in Google Scholar
  • 14 Cai X, Zhang Y, Li M. et al Association between prediabetes and risk of all cause mortality and cardiovascular disease: Updated meta-analysis. BMJ 2020; 370: m2297
    CrossrefPubMedSuche in Google Scholar
  • 15 Huang Y, Cai X, Chen P. Associations of prediabetes with all-cause and cardiovascular mortality: A meta-analysis. Ann Med 2014; 46: 684-692
    CrossrefPubMedSuche in Google Scholar
  • 16 Rajala U, Laakso M, Qiao Q. et al Prevalence of retinopathy in people with diabetes, impaired glucose tolerance, and normal glucose tolerance. Diabetes Care 1998; 21: 1664-1669
    CrossrefPubMedSuche in Google Scholar
  • 17 Tapp RJ, Shaw JE, Harper CA. et al The prevalence of and factors associated with diabetic retinopathy in the Australian population. Diabetes Care 2003; 26: 1731-1737
    CrossrefPubMedSuche in Google Scholar
  • 18 Kawasaki R, Wang JJ, Rochtchina E. et al Cardiovascular risk factors and retinal microvascular signs in an adult Japanese population: the Funagata study. Ophthalmology 2006; 113: 1378-1384
    CrossrefPubMedSuche in Google Scholar
  • 19 Munch IC, Kessel L, Borch-Johnsen K. et al Microvascular retinopathy in subjects without diabetes: the Inter99 eye study. Acta Ophthalmol 2012; 90: 613-619
    CrossrefPubMedSuche in Google Scholar
  • 20 Pang C, Jia L, Jiang S. et al Determination of diabetic retinopathy prevalence and associated risk factors in Chinese diabetic and pre-diabetic subjects: Shanghai diabetic complications study. Diabetes Metab Res Rev 2012; 28: 276-283
    CrossrefPubMedSuche in Google Scholar
  • 21 Sundling V, Platou CG, Jansson RW. et al Retinopathy and visual impairment in diabetes, impaired glucose tolerance and normal glucose tolerance: the Nord-Trondelag health study (the HUNT study). Acta Ophthalmol 2012; 90: 237-243
    CrossrefPubMedSuche in Google Scholar
  • 22 Hu Y, Teng W, Liu L. et al Prevalence and risk factors of diabetes and diabetic retinopathy in Liaoning province, China: A population-based cross-sectional study. PLoS One 2015; 10: e0121477
    CrossrefPubMedSuche in Google Scholar
  • 23 Sokolowska-Oracz A, Litwinczuk-Hajduk J, Piatkiewicz P. Prevalence of ocular abnormalities in prediabetic patients. Klin Oczna 2016; 118: 23-28
    PubMedSuche in Google Scholar
  • 24 Hanssen NMJ, Scheijen J, Houben A. et al Fasting and post-oral-glucose-load levels of methylglyoxal are associated with microvascular, but not macrovascular, disease in individuals with and without (pre)diabetes: The Maastricht Study. Diabetes Metab 2021; 47: 101148
    CrossrefPubMedSuche in Google Scholar
  • 25 Stroup DF, Berlin JA, Morton SC. et al Meta-analysis of observational studies in epidemiology: A proposal for reporting. Meta-analysis of observational studies in epidemiology (MOOSE) group. JAMA 2000; 283: 2008-2012
    CrossrefPubMedSuche in Google Scholar
  • 26 Higgins J, Green S. Cochrane Handbook for Systematic Reviews of interventions version 5.1.0. The Cochrane Collaboration 2011 www.cochranehandbook.org
    PubMed
  • 27 Wilkinson CP, Ferris FL, Klein RE. et al Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales. Ophthalmology 2003; 110: 1677-1682
    CrossrefPubMedSuche in Google Scholar
  • 28 Wells GA, Shea B, O'Connell D. et al The Newcastle-Ottawa scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. 2010 http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp
    PubMedSuche in Google Scholar
  • 29 Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med 2002; 21: 1539-1558
    CrossrefPubMedSuche in Google Scholar
  • 30 Patsopoulos NA, Evangelou E, Ioannidis JP. Sensitivity of between-study heterogeneity in meta-analysis: proposed metrics and empirical evaluation. Int J Epidemiol 2008; 37: 1148-1157
    CrossrefPubMedSuche in Google Scholar
  • 31 Egger M, Davey Smith G, Schneider M. et al Bias in meta-analysis detected by a simple, graphical test. BMJ 1997; 315: 629-634
    CrossrefPubMedSuche in Google Scholar
  • 32 Rett K, Gottwald-Hostalek U. Understanding prediabetes: definition, prevalence, burden and treatment options for an emerging disease. Curr Med Res Opin 2019; 35: 1529-1534
    CrossrefPubMedSuche in Google Scholar
  • 33 Shilpasree AS, Patil VS, Revanasiddappa M. et al Renal dysfunction in prediabetes: confirmed by glomerular hyperfiltration and albuminuria. J Lab Physicians 2021; 13: 257-262
    Thieme ConnectPubMedSuche in Google Scholar
  • 34 Kang Q, Yang C. Oxidative stress and diabetic retinopathy: Molecular mechanisms, pathogenetic role and therapeutic implications. Redox Biol 2020; 37: 101799
    CrossrefPubMedSuche in Google Scholar
  • 35 Wang W, Lo ACY. Diabetic retinopathy: pathophysiology and treatments. Int J Mol Sci 2018; 19: 1816
    CrossrefPubMedSuche in Google Scholar
  • 36 Gui F, You Z, Fu S. et al Endothelial dysfunction in diabetic retinopathy. Front Endocrinol (Lausanne) 2020; 11: 591
    CrossrefPubMedSuche in Google Scholar
  • 37 Perreault L, Pan Q, Schroeder EB. et al Regression from prediabetes to normal glucose regulation and prevalence of microvascular disease in the diabetes prevention program outcomes study (DPPOS). Diabetes Care 2019; 42: 1809-1815
    CrossrefPubMedSuche in Google Scholar