Is there an ethnic difference in the effect of risk factors for diabetic retinopathy?

Steven M. Haffner, Braxton D. Mitchell, Scot E. Moss, Michael P. Stern, Helen P. Hazuda, Judith Patterson, W. A.J. Van Heuven, Ronald Klein

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34 Scopus citations


Mexican Americans have an increased prevalence and incidence of non-insulin-dependent diabetes mellitus (NIDDM). In addition, Mexican American diabetic subjects have an increased prevalence of retinopathy relative to Caucasian diabetic subjects. In Mexican American diabetic subjects, established risk factors may have a stronger effect on diabetic retinopathy, compared to Caucasian diabetic subjects. In this report, we compare the effect of established risk factors (age at examination, gender, age at diagnosis of diabetes, duration of diabetes, glycemia, type of therapy, systolic and diastolic blood pressure, and hypertension prevalence) between Caucasian diabetic subjects (n = 478), a low-risk population for NIDDM (Wisconsin Epidemiologic Study of Diabetic Retinopathy), and Mexican American diabetic subjects (n = 231), a high-risk population for NIDDM (San Antonio Heart Study). Retinopathy was classified into two categories (any or none) as assessed by seven standard stereoscopic retinal photographs read at the University of Wisconsin Reading Center. Mexican American diabetic subjects in Texas had an increased prevalence of any retinopathy (odds ratio = 1.71, 95% confidence interval: 1.25, 2.34), compared to Caucasian diabetic subjects in Wisconsin. Longer duration of diabetes, more severe glycemia, earlier age at diagnosis, and insulin therapy were associated with diabetic retinopathy in both Mexican Americans and Caucasians. Socioeconomic status was not associated with prevalence of retinopathy. Moreover, the effect of risk factors for retinopathy was similar in both ethnic groups. These findings suggest that a differential effect of risk factors in Mexican American and Caucasian diabetic subjects does not explain the higher prevalence of retinopathy complications in the former, although we cannot exclude a more severe effect of glycemia on retinopathy in Mexican Americans since different measures of glycemia were used in each study.

Original languageEnglish (US)
Pages (from-to)2-8
Number of pages7
JournalAnnals of epidemiology
Issue number1
StatePublished - Jan 1993


  • Diabetic retinopathy
  • Mexican Americans
  • glycemia
  • non-insulin-dependent diabetes mellitus

ASJC Scopus subject areas

  • Epidemiology


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