Identifying Risk Factors for Clinically Significant Diabetic Macula Edema in Patients with Type 2 Diabetes Mellitus
Kyuzi Kamoi, Keiji Takeda, Kaoru Hashimoto, Reiko Tanaka and Shinya Okuyama
Affiliation: Center of Diabetes and Endocrine & Metabolism Disease, Nagaoka Red Cross Hospital, Nagaoka, Niigata 940-2085, Japan.
Keywords: Type 2 diabetes mellitus, Risk factors, Diabetic retinopathy, Diabetic macular edema, Clinically significant diabetic
macula edema (CSDME), Morning home blood pressure, Clinic blood pressure
High clinic blood pressure (BP), male sex, cigarette smoking, dyslipidemia, renal function, anemia and thiazolidenediones
(TZD) treatment are known predictors for clinically significant diabetic macula edema (CSDME). This study
was performed to identify the most significant risk factors for CSDME in Japanese patients with type 2 diabetes mellitus
(T2DM) and retinopathy (DR), using optical coherence tomography (OCT) if necessary, by multiple regression analysis.
One of the risk factors was BP in awakening.
Seven diabetic Japanese patients with CSDME (group 1) and 124 subjects without CSDME (group 2) with DR on OCT
The durations of T2DM in groups 1 and 2 were 15 ± 10 years and 20 ± 15 years, respectively. There was no significant
difference in sex distribution, duration, age, body mass index (BMI), and HbA1c, lipids (TC, LDL, TC/HDL), creatinine
and Hb levels, urinary albumin excretion rate, cigarette smoking, and clinic BP between two groups. Morning systolic
home BP (MSHBP) and foveal thickness were significantly (p<0.001) greater in group 1 than in group 2, and visual acuity
was significantly (p<0.001) lower in group 1 than group 2. The patients in both groups had received various kinds of
drugs for hyperglycemia, hypertension and others. There were no significant differences in the prevalence of other variables
between two groups.
On multiple regression analysis, MSHBP and nephropathy were significantly (p <0.03) positive predictors for CSDME,
while BMI had a significantly (p <0.001) negative predictor. Other variables were not significantly correlated to CSDME.
Thus, MSHBP is a predictive factor for CSDME that can be added to the previously reported risk factors in patient with
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