Lei CY, Xie JY, Ran QB, Zhang MX. Non-linear relationship between age and subfoveal choroidal thickness in Chinese patients with proliferative diabetic retinopathy. World J Diabetes 2024; 15(9): 1903-1915 [PMID: 39280183 DOI: 10.4239/wjd.v15.i9.1903]
Corresponding Author of This Article
Mei-Xia Zhang, MD, Chief Physician, Full Professor, Surgeon, Department of Ophthalmology and Research Laboratory of Macular Disease, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Wuhou District, Chengdu 610041, Sichuan Province, China. zhangmeixia@scu.edu.cn
Research Domain of This Article
Ophthalmology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Diabetes. Sep 15, 2024; 15(9): 1903-1915 Published online Sep 15, 2024. doi: 10.4239/wjd.v15.i9.1903
Table 1 Baseline characteristics of participants
Item
mean ± SD/n (%)
Age (year)
55.60 ± 10.03
SBP (mmHg)
136.98 ± 20.75
DBP (mmHg)
82.92 ± 10.90
Height (cm)
161.72 ± 8.16
Weight (kg)
62.91 ± 10.83
BMI (kg/m2)
23.99 ± 3.07
Duration of diabetes (year)
12.27 ± 6.80
Visual acuity (logMAR)
0.73 ± 0.53
IOP (mmHg)
16.28 ± 4.16
Fasting blood glucose (mmol/L)
7.40 ± 2.87
Serum urea nitrogen (mmol/L)
8.47 ± 4.39
Serum creatinine, µmol/L
145.98 ± 182.39
eGFR (mL/minutes × 1.73 m2)
66.95 ± 30.47
Uric acid (mmol/L)
377.59 ± 87.59
Triglyceride (mmol/L)
1.50 ± 0.75
Total cholesterol (mmol/L)
4.60 ± 1.19
HDL-C (mmol/L)
1.31 ± 0.41
LDL-C (mmol/L)
2.68 ± 1.02
HbA1c (%)
7.73 ± 1.74
Ocular axial length (mm)
23.17 ± 0.99
CMT (μm)
283.76 ± 122.66
SFCT (μm)
264.70 ± 83.28
Gender
Female
99 (42.31)
Male
135 (57.69)
Education level
Junior high school or below
147 (63.64)
Senior high school
40 (17.32)
College or above
44 (19.05)
Hypertension history
No
126 (53.85)
Yes
108 (46.15)
Diabetic nephropathy history
No
188 (80.34)
Yes
46 (19.66)
Stroke history
No
222 (94.87)
Yes
12 (5.13)
Anemia history
No
162 (69.23)
Yes
72 (30.77)
Heart disease history
No
222 (94.87)
Yes
12 (5.13)
PRP
None
111 (47.44)
Partial
43 (18.38)
Whole
80 (34.19)
Anti-VEGF therapy
No
175 (74.79)
Yes
59 (25.21)
Insulin treatment
No
113 (48.29)
Yes
121 (51.71)
Oral glucose-lowering drugs
No
59 (25.21)
Yes
175 (74.79)
Calcium antagonists
No
183 (78.54)
Yes
50 (21.46)
Table 2 Univariate linear regression analysis of subfoveal choroidal thickness measurements by enhanced depth imaging-optical coherence tomography
β, 95%CI
P value
Male vs female
31.08 (9.81 to 52.36)
0.0046
Age, per 1-year increase
-2.44 (-3.46 to -1.42)
< 0.0001
Education level
Junior high school or below
Reference
Senior high school
-19.95 (-48.87 to 8.97)
0.1778
College or above
2.39 (-25.48 to 30.26)
0.8666
SBP, per 1 mmHg increase
0.42 (-0.11 to 0.95)
0.1222
DBP, per 1 mmHg increase
1.27 (0.26 to 2.27)
0.0141
Height, per 1 cm increase
1.74 (0.41 to 3.08)
0.0111
Weight, per 1 cm increase
1.17 (0.17 to 2.17)
0.0234
BMI, per 1 kg/m2 increase
1.96 (-1.63 to 5.55)
0.2865
Duration of diabetes, per 1-year increase
-0.40 (-1.99 to 1.20)
0.6269
Hypertension vs absent
-2.97 (-24.42 to 18.48)
0.7862
Diabetic nephropathy history vs absent
40.23 (13.83 to 66.64)
0.0031
Stroke history vs absent
2.07 (-46.41 to 50.55)
0.9333
Anemia vs absent
12.80 (-10.31 to 35.91)
0.2788
Heart disease vs absent
-19.42 (-67.84 to 28.99)
0.4325
PRP
None
Reference
Partial
4.02 (-24.99 to 33.03)
0.7861
Whole
31.00 (7.32 to 54.69)
0.0109
Anti-VEGF therapy vs absent
30.55 (6.24 to 54.86)
0.0145
Insulin vs absent
23.81 (2.63 to 44.99)
0.0286
Oral glucose-lowering drugs vs absent
-28.96 (-53.31 to -4.62)
0.0205
Calcium antagonists vs absent
40.49 (14.86 to 66.13)
0.0022
Visual acuity, per 1 LogMAR increase
-12.24 (-32.49 to 8.01)
0.2374
IOP, per 1 mmHg increase
2.27 (-0.32 to 4.86)
0.0876
Fasting blood glucose, per 1 mmol/L increase
-2.34 (-6.06 to 1.39)
0.2201
Serum urea nitrogen, per 1 mmol/L increase
1.63 (-0.81 to 4.06)
0.1910
Serum creatinine, per 1 μmol/L increase
0.08 (0.02 to 0.14)
0.0092
eGFR, per 1 mL/minutes × 1.73m2 increase
-0.15 (-0.50 to 0.20)
0.3938
Uric acid, per 1 mmol/L
-0.01 (-0.14 to 0.11)
0.8322
Triglyceride, per 1 mmol/L increase
-3.01 (-24.36 to 18.34)
0.7828
Total cholesterol, per 1 mmol/L increase
-16.08 (-29.25 to -2.91)
0.0181
HDL-C, per 1 mmol/L increase
-42.66 (-81.44 to -3.89)
0.0329
LDL-C, per 1 mmol/L increase
-15.27 (-30.72 to 0.17)
0.0548
HbA1c, per 1 % increase
-5.36 (-16.77 to 6.04)
0.3590
CMT, per 1 μm increase
0.02 (-0.06 to 0.11)
0.5839
Ocular axial length, per 1 mm increase
-18.57 (-34.96 to -2.18)
0.0282
Table 3 Relationship between age and subfoveal choroidal thickness in different models
Exposure
Model I
Model II
Model III
β (95%CI)
P value
β (95%CI)
P value
β (95%CI)
P value
Age (year)
-2.23 (-3.29 to -1.18)
< 0.0001
-1.96 (-3.03 to -0.90)
0.0004
-1.68 (-2.97 to -0.39)
0.0117
Table 4 Non-linearity addressed by a two-piecewise linear regression model
For exposure: Age
SFCT (μm)
Outcome, Model
β
95%CI
P value
Fitting model by standardized linear regression
-1.68
-2.97 to -0.39
0.0117
Fitting model by two-piecewise linear regression
Inflection point of age
54.00
≤ 54
2.00
-0.16 to 4.17
0.0712
> 54
-4.89
-6.87 to -2.90
< 0.0001
Log likelihood ratio test
< 0.0010
Table 5 Results of stratified analysis between age and subfoveal choroidal thickness in patients with proliferative diabetic retinopathy
Y = SFCT, μm
n
β, 95%CI
P value
Gender
Female
99
-0.38 (-2.39 to 1.64)
0.7157
Male
135
-2.63 (-4.51 to -0.74)
0.0074
Hypertension history
No
126
-1.19 (-2.65 to 0.27)
0.1137
Yes
108
-3.27 (-5.42 to -1.12)
0.0037
Education level
Junior high school or below
147
-2.13 (-3.90 to -0.36)
0.0198
Senior high school
40
-0.72 (-4.44 to 3.00)
0.7086
College or above
44
-2.09 (-5.23 to 1.06)
0.2054
Diabetic nephropathy history
No
188
-1.76 (-3.06 to -0.46)
0.0089
Yes
46
-1.29 (-6.51 to 3.94)
0.6341
Stroke history
No
222
-1.48 (-2.80 to -0.16)
0.0294
Yes
12
Not applicable
Heart disease history
No
222
-1.61 (-2.90 to -0.32)
0.0153
Yes
12
Not applicable
Anemia history
No
162
-2.62 (-4.15 to -1.08)
0.0011
Yes
72
1.16 (-1.62 to 3.93)
0.4176
PRP
None
111
0.05 (-1.78 to 1.87)
0.9602
Partial
43
-3.64 (-6.62 to -0.66)
0.0257
Whole
80
-4.56 (-7.00 to -2.11)
0.0006
Anti-VEGF therapy
No
175
-1.03 (-2.56 to 0.50)
0.1891
Yes
59
-3.95 (-6.57 to -1.32)
0.0055
Insulin treatment
No
113
-1.16 (-2.82 to 0.49)
0.1711
Yes
121
-2.34 (-4.42 to -0.25)
0.0304
Oral glucose-lowering drugs
No
59
-2.85 (-5.15 to -0.56)
0.0180
Yes
175
-2.13 (-3.27 to -0.99)
0.0003
Calcium antagonists
No
183
-1.27 (-2.56 to 0.02)
0.0550
Yes
50
-3.00 (-7.47 to 1.48)
0.1993
Total cholesterol group (mmol/L)
< 6.22
119
-1.78 (-3.74 to 0.18)
0.0788
≥ 6.22
12
Not applicable
eGFR group (mL/minutes × 1.73 m2)
< 30
30
-3.83 (-8.33 to 0.68)
0.1198
≥ 30, < 60
61
-3.45 (-7.12 to 0.22)
0.0719
≥ 60, < 90
81
-1.47 (-4.21 to 1.27)
0.2976
≥ 90
62
0.11 (-1.87 to 2.08)
0.9161
Citation: Lei CY, Xie JY, Ran QB, Zhang MX. Non-linear relationship between age and subfoveal choroidal thickness in Chinese patients with proliferative diabetic retinopathy. World J Diabetes 2024; 15(9): 1903-1915