The prevalence of diabetic retinopathy (DR), risk factors for DR and the best diagnostic tests for prediction of DR in Africans with prediabetes (preDM) and diabetes (DM) are unknown. Evaluation for atrophy of the retinal inner layers may be helpful but has not been studied in Africans. Therefore, African-born blacks (n=249, male 63%, age 40±10y (mean±SD), BMI 27.8±4.5 kg/m2) living in the United States had OGTT and eye exams with spectral-domain optical coherence tomography (OCT) and fundus photos. A validated automated algorithm was applied to OCT images to measure thickness of retinal layers. Both A1C and glucose criteria during the OGTT was used to diagnose glucose tolerance status. Newly diagnosed DM occurred in 9.6% (24/249), preDM in 40.6% (101/249), normal glucose tolerance (NGT) in 49.8% (124/249). Retinopathy was present in 4% (10/249) overall, 20.8% (5/24) in those with DM, 1.9% (2/101) with preDM, and 2.4% (3/124) with NGT. The NGT cases with retinopathy had hypertension, anemia and/or thrombocytopenia and were excluded from DR analysis. Fasting plasma glucose had the highest correlation with DR (P<0.001), followed by 2h glucose from the OGTT (P=0.001). Higher total abdominal adipose tissue (TAT) was associated with DR (P=0.043). Higher waist circumference and age trended towards significance (P=0.054 and 0.075, resp). However, BP, BMI, years in the U.S., GFR, urine microalbumin:creatinine, CHOL, TG, HDL, LDL, hip circumference, % body fat and refractive error were not correlated. No correlations were found with A1C, fructosamine or glycated albumin. Neither DM nor preDM were associated with atrophy of the various retinal layers evaluated. The overall prevalence of DM and preDM combined was high (50.2%), and DR was present in 21% with DM. Higher FPG and 2-hr OGTT could be predictive of DR, and higher TAT was significantly associated with DR, but atrophy at different retinal layers was not. As the study is on-going, analyses will be repeated with a larger sample.


C.K. Hwang: None. E. Agron: None. M.A. Chen: None. C. DuBose: None. A.E. Sumner: None. E. Chew: None.

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