OVERT ALBUMINURIA PREDICTS DIABETIC-RETINOPATHY IN HISPANICS WITH NIDDM

Non-insulin-dependent diabetes mellitus (NIDDM) occurs with a higher f requency in Hispanic as compared with non-Hispanic whites. It also app ears that there is a higher prevalence of diabetic nephropathy in the Hispanic population when compared with non-Hispanic whites. In the cur rent study, 144 Hispanics and 671 non-Hispanic white NIDDM subjects we re studied to determine the possible association of various risk facto rs and diabetic complications, including overt albuminuria, with diabe tic retinopathy, Stereoscopic retinal fundus photographs were obtained and graded by the University of Wisconsin Fundus Photographic Reading Center. We also sought to determine whether risk factors for retinopa thy vary between Hispanics and non-Hispanic whites. In the total group , duration of diabetes, glycosylated hemoglobin, neuropathy, diastolic hypertension, use of insulin, and Hispanic ethnicity correlated with the presence of retinopathy. Controlling for severity and duration of diabetes, Hispanics had a significantly increased risk of retinopathy relative to non-Hispanic whites (OR = 2.13, 95% CI = 1.34, 3.37, P = 0 .0013). Duration of diabetes and presence of neuropathy were significa ntly correlated with the presence of diabetic retinopathy in Hispanics and non-Hispanic whites. The presence of overt albuminuria (>200 mu g /min), although not related to diabetic retinopathy in non-Hispanic wh ites, conferred a high risk for diabetic retinopathy in Hispanics (OR = 11.14, CI = 1.20, 103.39, P = 0.0339) independent of other risk fact ors. In summary, Hispanics with NIDDM have an increased prevalence of diabetic retinopathy when compared with non-Hispanic whites, In additi on, overt albuminuria in the Hispanic subjects appears to be a powerfu l predictor of the diabetic retinopathy, (C) 1998 by the National Kidn ey Foundation, Inc.