Study On The Association Between Hemoglobin Levels And Diabetic Retinopathy In Type 2 Diabetes Mellitus

Objective: The study was conducted to evaluate the association between hemoglobin levels(Hb)levels and diabetic retinopathy(DR)risk in Chinese patients with type 2 diabetes mellitus(T2DM).Methods: In the cross-sectional study,we enrolled a total of 629 T2 DM patients aged?18 years who were hospitalized in Affiliated Hospital of Jining Medical University from July 1,2017 to June 30,2018.The survey collected basic information including name,age,gender,duration of DM,past history,smoking and drinking history,family history,diabetic complications;physical examination data including height,weight,waist circumference,calculated the body mass index;laboratory examination including blood routine,urinalysis,liver function,kidney function,fasting plasma glucose,serum lipid,thyroid function,plasma electrolytes,glycosylated hemoglobin,blood ketone bodies,urinary microalbuminuria,insulin and c-peptide releasing tests(0,30,60,120,180 minutes),calculated the estimated glomerular filtration(eGFR),etc.All the participants underwent an ophthalmic examination,including fundus photographs.They were divided into DR and non-diabetic retinopathy(NDR)group based on the results of fundus examination.Anemia was defined according to Chinese anemia criteria.The analysis was used to investigated the relationship between Hb levels and DR risk.Results: Significant differences were observed in the hemoglobin level between T2 DM patients with and without DR.The mean Hb levels in the patients with DR(12.76±1.72 g/dL)were lower than patients without DR(13.81±1.61g/dL),and the patients with DR had a higher prevalence of anemia(19.3%)compared to those without DR(4.6%).An analysis of univariate was performed to show the rate of DR was significantly negatively correlated with Hb levels and triglyceride(<0.05),whereas the DR risk was significantly positively correlated with age,duration,hypertension,diabetic nephropathy,anemia,fasting plasma glucose,and serum creatinine(P<0.05).The results of multivariate linear regression suggested that the risk of DR exhibited a decreasing trend with increasing Hb levels in the subjects,and a 29% decrease in DR risk was found with a 1.0g/dL increase in hemoglobin level(OR=0.713,95%CI:0.598-0.850,P<0.001).Conclusions: Our study suggested a negative relationship between the Hb levels and rate of DR in patients with T2 DM.The finding indicates that high Hb levels are significantly related to a decreased DR risk in T2 DM patients.