Department of Ophthalmology, A. J. Institute of Medical Sciences and Research Centre, Mangalore, Karnataka, India.
Indian J Ophthalmol. 2021 Mar;69(3):661-665. doi: 10.4103/ijo.IJO_253_20.
To assess the role of dietary factors in the development of diabetic retinopathy (DR) in diabetics.
This prospective study was carried out on patients attending the outpatient department of ophthalmology for a period of 1 year. An interview-based 24-hour diet recall was used to document average daily dietary nutrient intakes. Each patient was subjected to a comprehensive ocular examination to look for DR.
A total of 261 patients attending the outpatient department of ophthalmology were the participants for this study. The mean (±SD) age of the participants was 57.73 ± 11.29 years, and 67% were men. One hundred and six participants had DR. Univariate analysis revealed sex, duration, fish (times/week), egg (yes/no), rice lunch (yes/no), rice dinner, rice (boiled/white), and total calorie intake to be associated with DR (P < 0.05). Logistic regression multivariable analysis revealed males (OR: 3.20, 95% CI: 1.65-6.19), longer duration of diabetes (OR:1.05,95% CI:1.01-1.11), antioxidant intake (OR: 3.42, 95% CI: 1.65-7.05), and consumption of rice (OR: 3.19, 95% CI: 1.17-8.69) to have significant association with DR (P < 0.05), with the odds of developing DR increasing three times in these patients. The odds of developing DR were lesser with more frequent (>2 times/week) fish consumption (OR: 0.42, 95% CI: 0.18-0.94) and in patients on pharmacological treatment for diabetes mellitus (OR: 0.16, 95% CI: 0.04-0.58). Binary logistic regression revealed chapathi consumption (OR: 9.37, 95% CI: 1.64-53.68) to be associated with severe forms and fish consumption (OR: 0.06, 95% CI: 0.01-1.06) (P < 0.05) to be associated with less severe forms of DR.
Males, longer duration of diabetes, antioxidant intake, fish consumption, and consumption of rice were associated with the occurrence of DR. Participants with diabetes who consumed fish more frequently and those who were on pharmacological treatment for diabetes mellitus had a significantly lower risk of DR and frequent fish consumption could reduce the risk of DR progression.
评估饮食因素在糖尿病患者糖尿病视网膜病变(DR)发展中的作用。
本前瞻性研究对在眼科门诊就诊的患者进行了为期 1 年的研究。采用基于访谈的 24 小时饮食回忆法记录平均每日膳食营养素摄入量。对每位患者进行全面的眼部检查以寻找 DR。
共有 261 名在眼科门诊就诊的患者参加了这项研究。参与者的平均(±SD)年龄为 57.73 ± 11.29 岁,其中 67%为男性。有 106 名参与者患有 DR。单因素分析显示,性别、病程、鱼(次/周)、蛋(是/否)、米饭午餐(是/否)、米饭晚餐、米饭(煮/白)和总热量摄入与 DR 相关(P<0.05)。多变量 logistic 回归分析显示,男性(OR:3.20,95%CI:1.65-6.19)、糖尿病病程较长(OR:1.05,95%CI:1.01-1.11)、抗氧化剂摄入(OR:3.42,95%CI:1.65-7.05)和食用大米(OR:3.19,95%CI:1.17-8.69)与 DR 有显著相关性(P<0.05),这些患者患 DR 的风险增加了三倍。吃鱼更频繁(>2 次/周)(OR:0.42,95%CI:0.18-0.94)和接受糖尿病药物治疗(OR:0.16,95%CI:0.04-0.58)的患者发生 DR 的几率较小。二项逻辑回归显示,食用 chapathi(OR:9.37,95%CI:1.64-53.68)与严重形式相关,而食用鱼类(OR:0.06,95%CI:0.01-1.06)(P<0.05)与较轻形式的 DR 相关。
男性、糖尿病病程较长、抗氧化剂摄入、鱼类摄入和食用大米与 DR 的发生有关。吃鱼更频繁和接受糖尿病药物治疗的糖尿病患者发生 DR 的风险显著降低,而频繁食用鱼类可能会降低 DR 进展的风险。