The aim of the study was to investigate whether body mass index (BMI) independently or in correlation with other risk factors is associated with diabetic retinopathy (DR) progression. The study included 545 patients with type 2 diabetes. According to DR status, they were divided into three groups: group 1 (no retinopathy; ), group 2 (mild/moderate nonproliferative DR; ), and group 3 (severe/very severe NPDR or proliferative DR; ). Patients without DR were younger than those with signs of retinopathy at time of diabetes onset whilst diabetes duration was longer in groups with severe NPDR and PDR. DR progression was correlated with diabetes duration, BMI, HbA1c, hypertension, and cholesterol. Statistical analyses showed that the progression of retinopathy increased significantly with higher BMI (gr. 1: 26.50 ± 2.70, gr. 2: 28.11 ± 3.00, gr. 3: 28.69 ± 2.50; ). We observed a significant deterioration of HbA1c and a significant increase in cholesterol and hypertension with an increase in BMI. Correlation between BMI and triglycerides was not significant. Thus, BMI in correlation with HbA1c cholesterol and hypertension appears to be associated with the progression of DR in type 2 diabetes and may serve as a predictive factor for the development of this important cause of visual loss in developed countries. 1. Introduction Overweight (body mass index, BMI ≥ 25？kg/m2) and obesity (BMI ≥ 30？kg/m2) have become a growing global public health problem with increasing prevalence in many affluent societies as well as in developing countries [1–3]. Currently, 300 million people are considered to be obese and due to this rising trend, it is anticipated that this figure could double by the year of 2025. Addressing the problem of obesity becomes important since being a disease itself it represents a risk for many metabolic and cardiovascular diseases including type 2 diabetes [4]. The number of patients with type 2 diabetes is rapidly increasing in many countries around the world irrespective of its phase of development. It is projected that by 2025 there will be 380 million people with type 2 diabetes and 418 million people with impaired glucose tolerance owing to an increase in obesity, inactivity, life span extension, and better detection of the disease [5]. This global increase of diabetes incidence has a significant impact on the prevalence of diabetic complications among which diabetic retinopathy (DR) takes an important place [6, 7]. DR is a leading cause of acquired blindness in working-age adults and has been estimated to represent 12% of blindness in developed
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