Higher Prevalence of Retinopathy in Diabetic Patients of South Asian Ethnicity Compared With White Europeans in the Community

Higher Prevalence of Retinopathy in Diabetic Patients of South Asian Ethnicity Compared With White Europeans in the Community A cross-sectional study Neil T. Raymond , MSC 1 , Lakshminarayanan Varadhan , MRCP 2 , Dilini R. Reynold , MD 3 , Kate Bush , BM 4 , Sailesh Sankaranarayanan , MRCP 2 , Srikanth Bellary , MRCP 5 , Anthony H. Barnett , FRCP 5 , Sudhesh Kumar , FRCP 6 , J. Paul O'Hare , FRCP 6 and on behalf of the UK Asian Diabetes Study Retinopathy Study Group 1 Health Sciences Research Institute, Warwick Medical School, University of Warwick, Coventry, U.K 2 SHO Diabetes, University Hospital Coventry and Warwickshire NHS Trust, Clifford Bridge Road, Coventry, U.K. 3 Warwick Medical School, University of Warwick, Coventry, U.K. 4 ST2 Ophthalmology, Southampton General Hospital, Southampton, U.K. 5 Heart of England NHS Foundation Trust, Bordesley Green East, Birmingham, U.K. 6 Clinical Sciences Research Institute, Warwick Medical School, University of Warwick, Coventry, U.K. Corresponding author: J. Paul O'Hare, j.p.o-hare{at}warwick.ac.uk Abstract OBJECTIVE —The purpose of this study was to compare prevalence and risk factors for diabetic retinopathy among U.K. residents of South Asian or white European ethnicity. RESEARCH DESIGN AND METHODS —This was a community-based cross-sectional study involving 10 general practices; 1,035 patients with type 2 diabetes were studied: 421 of South Asian and 614 of white European ethnicity. Diabetic retinopathy, sight-threatening retinopathy, maculopathy, and previous laser photocoagulation therapy were assessed after grading of retinal photographs. Data were collected on risk factors including age, duration, and treatment of diabetes, blood pressures, serum total cholesterol, and A1C. RESULTS —Patients of South Asian ethnicity had significantly higher systolic (144 vs. 137 mmHg, P < 0.0001) and diastolic (84 vs. 74 mmHg, P < 0.0001) blood pressure, A1C (7.9 vs. 7.5%, P < 0.0001), and total cholesterol (4.5 vs. 4.2 mmol/l, P < 0.0001). Diabetic retinopathy was detected in 414 (40%) patients (189 South Asian [45%] versus 225 white European [37%]; P = 0.0078). Sight-threatening retinopathy was detected in 142 (14%) patients (68 South Asian [16%] versus 74 white European [12%]; P = 0.0597). After adjustment for confounders, there were significantly elevated risks of any retinopathy and maculopathy for South Asian versus white European patients. CONCLUSIONS —Patients of South Asian ethnicity had a significantly higher