Relationship between body fat and diabetic retinopathy in patients with type 2 diabetes: a nationwide survey in Korea

Purpose To evaluate the association of body mass index (BMI), waist circumference, and body fat with diabetic retinopathy (DR) in Korean patients with type 2 diabetes. Methods Among the 1130 participants 19 years of age or older with type 2 diabetes enrolled in the nationwide survey, a total of 887 participants were included in the analyses after excluding patients with ungradable fundus images. The presence and severity of DR were graded with seven-field fundus photographs. The associations between DR and anthropometric parameters and total body fat, which was assessed by dual-energy X-ray absorptiometry, were analysed using multivariate logistic regression models. Results Patients were divided into three groups according to severity of DR: no DR ( n = 702, 79.1%), mild/moderate DR ( n = 130, 14.7%), and vision-threatening DR ( n = 55, 6.2%). In multivariate-adjusted analyses, higher BMI (adjusted odds ratio [aOR], 0.80; 95% confidence interval [CI], 0.70–0.92; P = 0.001), larger waist circumference (aOR, 0.96; 95% CI, 0.91–1.00; P = 0.047), and higher total body fat (aOR, 0.86; 95% CI, 0.79–0.92; P