Liu Yuan, Liu Kaiqun, Xie Liqiong, Zuo Chengguo, Wang Lanhua, Huang Wenyong
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China.
Heliyon. 2024 Aug 22;10(17):e36683. doi: 10.1016/j.heliyon.2024.e36683. eCollection 2024 Sep 15.
To investigate sex-specific differences in associations of abdominal obesity indexes, systemic factors, and diabetic retinopathy (DR) in type 2 diabetes mellitus (T2DM) subjects with normal body mass index (BMI).
This cross-sectional study comprised 653 T2DM subjects (402 women and 251 men) with normal BMI (18.5 kg/m<BMI<24.0 kg/m). All participants completed a standard questionnaire and underwent comprehensive ocular and systemic examinations. Anthropometric parameters were measured and recorded, including weight, height, waist circumference (WC), hip circumference, waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). Sex-specific associated factors for DR were assessed using logistic regression models.
In the multivariate logistic regressions, the presence of any DR was associated with a longer duration of T2DM (OR = 1.07, p = 0.007) and higher HbA1c (OR = 1.40, p = 0.001) in women, while any DR was associated with younger age at T2DM diagnosis (OR = 0.94, p = 0.020) and higher HbA1c (OR = 1.29, p = 0.011) in men. For women, we identified a positive association between WC (OR = 1.07, p = 0.011), WHR (OR = 1.67, p = 0.002), and WHtR (OR = 1.57, p = 0.004) with any DR after adjusting for confounders, and the third tertiles of WC (OR = 2.29, p = 0.028), WHR (OR = 3.03, p = 0.003), and WHtR (OR = 2.84, p = 0.007) were at high risk of any DR. For men, there were no associations between abdominal obesity indexes and any DR in either continuous variables or categorical variables (all p > 0.05).
There were sex differences in the relationships between WC, WHR, WHtR, and DR in this T2DM population with normal BMI. Our findings provide new insight into a sex-specific mechanism of DR and management of the condition.
研究体重指数（BMI）正常的2型糖尿病（T2DM）患者腹部肥胖指数、全身因素与糖尿病视网膜病变（DR）之间的性别差异。
这项横断面研究纳入了653名BMI正常（18.5kg/m²<BMI<24.0kg/m²）的T2DM患者（402名女性和251名男性）。所有参与者均完成了一份标准问卷，并接受了全面的眼部和全身检查。测量并记录人体测量参数，包括体重、身高、腰围（WC）、臀围、腰臀比（WHR）和腰高比（WHtR）。使用逻辑回归模型评估DR的性别特异性相关因素。
在多变量逻辑回归中，女性中任何DR的存在与T2DM病程较长（OR = 1.07，p = 0.007）和较高的糖化血红蛋白（HbA1c）水平（OR = 1.40，p = 0.001）相关，而男性中任何DR与T2DM诊断时年龄较小（OR = 0.94，p = 0.020）和较高的HbA1c水平（OR = 1.29，p = 0.011）相关。对于女性，在调整混杂因素后，我们发现WC（OR = 1.07，p = 0.011）、WHR（OR = 1.67，p = 0.002）和WHtR（OR = 1.57，p = 0.004）与任何DR之间存在正相关，且WC、WHR和WHtR的第三个三分位数（OR分别为2.29，p = 0.028；OR = 3.03，p = 0.003；OR = 2.84，p = 0.007）发生任何DR的风险较高。对于男性，腹部肥胖指数与任何DR在连续变量或分类变量中均无关联（所有p>0.05）。
在该BMI正常的T2DM人群中，WC、WHR、WHtR与DR之间的关系存在性别差异。我们的研究结果为DR的性别特异性机制和病情管理提供了新的见解。
