Table 4.

Studies Investigating Relationship between Obesity and Diabetic Retinopathy

Study			Definition of diabetic retinopathy	Summary of main findings	Reference
Year	Type	Population
2003	PB, P	The Hoorn Study	Ophthalmoscopy and fundus photography	Higher WHR (OR 8.67) associated with retinopathy, but not for BMI	208
2003	PB, P	Diabetes Incidence Study in Sweden (DISS) (79% type 1 diabetes)	Retinal photographs	Higher BMI associated with earlier development of retinopathy (RR 1.11)	83
2001	PB, P	EURODIAB Prospective Complications Study (persons with type 1 diabetes)	Retinal photographs	Higher WHR (OR 1.32) associated with diabetic retinopathy	24
1986	PB, P	1031 persons with diabetes mellitus	Incident diabetic retinopathy Ocular examination	Obesity associated with increased risk of retinopathy (hazard ratio 2.01)	8
2001	PB, C	Diabetes Control and Complications Trial (DCCT)	Ocular Examination	Higher BMI (OR 1.11) associated with diabetic retinopathy after adjustment for metabolic control	228
2002	PB, C	The Hoorn Study	Ophthalmologic examination and fundus photography	Higher BMI (OR 1.3) associated with retinopathy	207
1984	PB, C	Wisconsin Epidemiologic Study of Diabetic Retinopathy	Ocular examination and retinal photography	Small body mass associated with more severe retinopathy	114
1998	PB, C	911 of 6553 participants from survey on the Indian Ocean island of Mauritius	Retinal photographs with grading according to modified Airlie House criteria	Lower BMI associated with retinopathy	41
2005	HP, C	156 persons with diabetes mellitus	Ocular examinations	Higher BMI associated with increased prevalence of retinopathy (40.8% in BMI≤25, 63.4% in BMI 26–29.9, 63.6% in BMI≥30)	101

BMI = Body Mass Index, OR = Odds Ratio, RR = Relative Risk, CI = Confidence Interval, PB = Population-based, HP = Hospital-based, P = Prospective data, C = Cross-sectional data