Association between visceral fat area and diabetic retinopathy among people with type 2 diabetes mellitus: a cross-sectional study in Ningbo, Zhejiang Province, China

TL;DR

This study finds a modest link between higher visceral fat and diabetic retinopathy in type 2 diabetes patients in Ningbo, China.

Contribution

The study identifies a novel association between visceral fat area and diabetic retinopathy in a Chinese T2DM population.

Findings

Higher visceral fat area is modestly associated with increased diabetic retinopathy risk.

The association remains significant regardless of BMI categories.

Visceral fat area increases with DR severity, though not statistically significant.

Abstract

The objective of this study is to investigate the relationship between visceral fat area (VFA) and diabetic retinopathy (DR) in the context of type 2 diabetes mellitus (T2DM) within Ningbo, China.

The data of a total of 3,707 subjects with T2DM treated at The First Affiliated Hospital of Ningbo University were enrolled. The existence and severity of diabetic retinopathy were assessed by employing the 45° two-field stereoscopic digital photography. Subjects were categorized into four distinct groups: those without DR (NDR), individuals with mild non-proliferative DR (mild NPDR), people with moderate non-proliferative DR (moderate NPDR), and those suffering from vision-threatening DR (VTDR). Bio-electrical impedance was employed to estimate the Visceral fat area (VFA). Multinomial logistic regression models were utilized to evaluate the association between VFA and DR.

The mean VFA in patients without diabetic retinopathy (NDR) was notably lower compared to that of patients with diabetic retinopathy (DR) (85.21 ± 37.78 vs. 97.37 ± 44.58 cm2, p < 0.001). As the severity of DR increased, VFA increased gradually but insignificantly (94.41 ± 43.13 cm2, 96.75 ± 40.82 cm2, 100.84 ± 49.34 cm2, p = 0.294). After adjusting the confounding factors, there was an association identified between VFA and the occurrence of DR (OR = 1.020, 95% CI = 1.016–1.024). It showed that regardless of BMI, whether it’s less than 25 kg/m2 or greater than or equal to 25 kg/m2, a higher VFA (≥100 cm2) level came with a higher prevalence of DR (p < 0.001).

The outcomes of this research indicate a modest association between VFA and the incidence of DR among Chinese patients who have been diagnosed with T2DM in Ningbo.

Figures