Predictors for diabetic retinopathy in normoalbuminuric people with type 2 diabetes mellitus

A total 310 patients with type 2 DM and normoalbuminuria, who were referred to the Department of Ophthalmology for screening of DR were included in this study. DR was clinically graded according to the International Clinical Diabetic Retinopathy guidelines. The urinary albumin excretion rate (UAER) was assessed via 24-hour urine collection and measured by immunoturbidimetric assay. Normoalbuminuria was defined as a UAER？<？20？μg/min in 2 out of 3 consecutive tests taken within 2–3？months.DR of any grade was present in 64/310 (20.7？%) patients. Mild non-proliferative diabetic retinopathy (NPDR) was most prevalent in patients with DR of any grade (36/64, 56？%). The duration of diabetes (OR 1.01, 95？% CI, 1.01 – 1.02, p？<？0.001), hemoglobin levels (OR 0.73, 95？% CI, 0.59 – 0.91, p？=？0.004) and a higher tertile of UAER (OR 4.04, 95？% CI, 1.71 – 9.57, p？=？0.001) had independently significant association with DR. NPDR as well as PDR was more prevalent in patients with higher tertile of UAER compared with those with lower tertile of UAER (NPDR, p？=？0.002 and PDR, p？=？0.027, respectively).Our findings suggest that patients with normoalbuminuric type 2 DM also require close monitoring for the early detection of DR, especially if they have a higher UAER, longer duration of diabetes, or lower hemoglobin levels.Diabetic retinopathy (DR) is one of the leading causes of visual impairment and blindness in people with diabetes mellitus (DM) [1-3]. As the prevalence of DM increases, the development of DR as a microvascular complication of DM also rises. Furthermore, previous studies demonstrated that DR has also been associated with cardiovascular and all cause mortality as well as visual morbidity in patients with type 2 DM [4,5], which adds value to investigating the prevalence and risk factors for DR.Microalbuminuria is a marker of endothelial dysfunction and may influence on alterations in the microvasculature of retina and kidneys. Previous studies have demonstrated that microal