Prevalence and associations of diabetic retinopathy in a large cohort of prediabetic subjects: the Gutenberg Health Study

Julia Lamparter, Philipp Raum, Norbert Pfeiffer, Tunde Peto, René Höhn, Heike Elflein, Philipp Wild, Andreas Schulz, Astrid Schneider, Alireza Mirshahi

Research output: Contribution to journalArticlepeer-review

38 Citations (Scopus)


AIMS: To evaluate the prevalence of diabetic retinopathy/maculopathy (DR/DMac) and its associations with cardiovascular risk factors (CRF) in participants with prediabetes (PwPD) in a large European cohort within the population-based Gutenberg Health Study (GHS).

METHODS: The study was based on a sub-cohort of the GHS (n=5,000, age: 35-74 y). Prediabetes was diagnosed according to HbA1c levels (5.7-6.4%). DR/DMac was graded from fundus photographs. Blood samples and comprehensive questionnaires served for evaluation of laboratory results and CRF.

RESULTS: The prevalence of prediabetes was 22.4%, and of DR/DMac 8.1%/0.2%, respectively. The majority of participants had mild DR (7.2%). A percentage of 0.5 of PwPD presented with moderate and 0.3% with severe non-proliferative disease. None of the subjects had proliferative DR. No independent association was found between any of the analyzed CRF [hypertension, smoking, (family) history of myocardial infarction, congestive heart failure, coronary heart disease, stroke, obesity, dyslipidemia, chronic obstructive pulmonary disease, peripheral artery disease and chronic kidney disease] and DR.

CONCLUSIONS: Although prevalences of prediabetes and DR in this Caucasian cohort are considerable, retinopathy findings are mainly mild, and no association was found for DR/DMac and CRF.

Original languageEnglish
Pages (from-to)482-287
Number of pages6
JournalJournal of diabetes and its complications
Issue number4
Early online date26 Feb 2014
Publication statusPublished - 19 Mar 2014


  • Adult
  • Aged
  • Cardiovascular Diseases
  • Cohort Studies
  • Diabetic Angiopathies
  • Diabetic Cardiomyopathies
  • Diabetic Retinopathy
  • Female
  • Germany
  • Hemoglobin A, Glycosylated
  • Humans
  • Macular Degeneration
  • Male
  • Middle Aged
  • Prediabetic State
  • Prevalence
  • Retina
  • Risk Factors
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Journal Article
  • Observational Study
  • Research Support, Non-U.S. Gov't

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