Inter-Relations between Dietary Patterns and Glycemic Control-Related Biomarkers on Risk of Retinopathy in Type 2 Diabetes

Wu, Yu-Ju; Hsu, Chih-Cheng; Hwang, Shang-Jyh; Lin, Kun-Der; Lin, Pi-Chen; Huang, Ya-Fang; Lee, Chien-Hung; Chang, Chiao-I; Huang, Meng-Chuan

doi:10.3390/nu16142274

Open AccessArticle

Inter-Relations between Dietary Patterns and Glycemic Control-Related Biomarkers on Risk of Retinopathy in Type 2 Diabetes

by

Yu-Ju Wu

^1,2,

Chih-Cheng Hsu

^3,4,5,6

,

Shang-Jyh Hwang

^7,8,

Kun-Der Lin

⁹

,

Pi-Chen Lin

⁸,

Ya-Fang Huang

³,

Chien-Hung Lee

¹⁰

,

Chiao-I Chang

² and

Meng-Chuan Huang

^1,2,*

¹

Department of Nutrition and Dietetics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807378, Taiwan

²

Graduate Institute of Medicine and Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan

³

Institute of Population Health Sciences, National Health Research Institutes, Miaoli County 350401, Taiwan

⁴

Department of Health Services Administration, China Medical University, Taichung 4064040, Taiwan

⁵

Department of Family Medicine, Min-Sheng General Hospital, Taoyuan 330056, Taiwan

⁶

National Center for Geriatrics and Welfare Research, National Health Research Institutes, Yunlin 632007, Taiwan

⁷

Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807378, Taiwan

⁸

Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807378, Taiwan

⁹

The Lin’s Clinics, Kaohsiung 807057, Taiwan

¹⁰

Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung 807378, Taiwan

^*

Author to whom correspondence should be addressed.

Nutrients 2024, 16(14), 2274; https://doi.org/10.3390/nu16142274

Submission received: 16 May 2024 / Revised: 27 June 2024 / Accepted: 10 July 2024 / Published: 15 July 2024

(This article belongs to the Section Nutrition and Diabetes)

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Abstract

Diabetic retinopathy (DR), which can cause vision loss, may progress faster with poor glycemic control and oxidative stress. This study aims to examine how dietary patterns and glycemic control biomarkers relate to retinopathy risk in type 2 diabetes patients. In this study, we enrolled diabetic patients with retinopathy (DR) (n = 136) and without retinopathy (no DR) (n = 466) from a cohort of participants in the “Blood Pressure Control to Reduce the Risk of Type 2 Diabetic Nephropathy Study”. Hemoglobin A1c (HbA1c) and malondialdehyde were defined as elevated when their levels reached ≥8.5% and ≥2/3 (16.2 μm), respectively. Dietary data were collected by a food frequency questionnaire. Dietary patterns were identified by factor analysis. Elevated HbA1c was significantly correlated with increased risk of DR (OR: 2.12, 95% CI: 1.14–3.93, p = 0.017). In subjects with a high animal protein and processed food dietary pattern (≥highest tertile score) or a low vegetable intake pattern (<highest tertile score), elevated HbA1c was significantly associated with a 4.44-fold (95% CI: 1.34–14.68, p = 0.015), 3.96-fold (95% CI: 1.12–14.04, p = 0.033), and 2.57-fold (95% CI: 1.16–5.67, p = 0.020) increase in the risk of DR, respectively, compared to subjects with HbA1c levels < 8.5%. When stratifying subjects with a high animal protein pattern, higher MDA levels were significantly correlated with an increased risk of DR (OR: 2.93, 95% CI: 1.33–6.48, p = 0.008). Poor glycemic control increases the risk of retinopathy in patients with type 2 diabetes, and combined with diets low in vegetables and high in animal protein or processed food may exacerbate the risk of DR. The findings of this study should be further investigated in prospective studies.

Keywords: diabetic retinopathy; glycated hemoglobin A1c; malondialdehyde

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MDPI and ACS Style

Wu, Y.-J.; Hsu, C.-C.; Hwang, S.-J.; Lin, K.-D.; Lin, P.-C.; Huang, Y.-F.; Lee, C.-H.; Chang, C.-I.; Huang, M.-C. Inter-Relations between Dietary Patterns and Glycemic Control-Related Biomarkers on Risk of Retinopathy in Type 2 Diabetes. Nutrients 2024, 16, 2274. https://doi.org/10.3390/nu16142274

AMA Style

Wu Y-J, Hsu C-C, Hwang S-J, Lin K-D, Lin P-C, Huang Y-F, Lee C-H, Chang C-I, Huang M-C. Inter-Relations between Dietary Patterns and Glycemic Control-Related Biomarkers on Risk of Retinopathy in Type 2 Diabetes. Nutrients. 2024; 16(14):2274. https://doi.org/10.3390/nu16142274

Chicago/Turabian Style

Wu, Yu-Ju, Chih-Cheng Hsu, Shang-Jyh Hwang, Kun-Der Lin, Pi-Chen Lin, Ya-Fang Huang, Chien-Hung Lee, Chiao-I Chang, and Meng-Chuan Huang. 2024. "Inter-Relations between Dietary Patterns and Glycemic Control-Related Biomarkers on Risk of Retinopathy in Type 2 Diabetes" Nutrients 16, no. 14: 2274. https://doi.org/10.3390/nu16142274

APA Style

Wu, Y.-J., Hsu, C.-C., Hwang, S.-J., Lin, K.-D., Lin, P.-C., Huang, Y.-F., Lee, C.-H., Chang, C.-I., & Huang, M.-C. (2024). Inter-Relations between Dietary Patterns and Glycemic Control-Related Biomarkers on Risk of Retinopathy in Type 2 Diabetes. Nutrients, 16(14), 2274. https://doi.org/10.3390/nu16142274

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Inter-Relations between Dietary Patterns and Glycemic Control-Related Biomarkers on Risk of Retinopathy in Type 2 Diabetes

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