Dietary iron intake is nonlinearly associated with the risk of diabetic retinopathy in adults with type 2 diabetes
Abstract Objective To elucidate the association between dietary iron intake and diabetic retinopathy (DR) in type 2 diabetes (T2D) patients. Methods Participants from the National Health and Nutrition Examination Survey (NHANES) 2005–2008 aged over 40 years with T2D were included. Dietary iron intak...
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BMC
2025-04-01
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| Series: | BMC Endocrine Disorders |
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| Online Access: | https://doi.org/10.1186/s12902-025-01926-z |
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| author | Xiaoyun Chen Yihang Fu Hongyu Si Wenfei Li Weimin Yang Wei Xiao |
| author_facet | Xiaoyun Chen Yihang Fu Hongyu Si Wenfei Li Weimin Yang Wei Xiao |
| author_sort | Xiaoyun Chen |
| collection | DOAJ |
| description | Abstract Objective To elucidate the association between dietary iron intake and diabetic retinopathy (DR) in type 2 diabetes (T2D) patients. Methods Participants from the National Health and Nutrition Examination Survey (NHANES) 2005–2008 aged over 40 years with T2D were included. Dietary iron intake was estimated from standardised questionnaires. The presence of DR and vision-threatening DR (VTDR) was determined through retinal imaging. We used logistic regression to assess the relationship between iron intake and DR, and restricted cubic splines to reveal nonlinear links. Results The study enrolled 1172 T2D adults. We found significant nonlinear associations between dietary iron intake and DR among females (P = 0.023), but not in males (P = 0.490). Compared with the lowest quartile of iron intake, the third quartile (13.2–18.1 mg/d) yielded significantly lower odds of developing DR (odds ratio [OR], 0.59; 95% CI, 0.39–0.90) and VTDR (OR, 0.42; 95% CI, 0.19–0.94). Stratified logistic analyses showed that medium-high iron intake was associated with lower risks of DR in females (OR, 0.44; 95% CI, 0.24–0.81), non-Hispanic Blacks (OR, 0.38; 95% CI, 0.17–0.85), and individuals with obesity (OR, 0.45; 95% CI, 0.25–0.82), high HbA1c (OR, 0.56; 95% CI, 0.34–0.93), long diabetes duration (OR, 0.40; 95% CI, 0.21–0.76) or low blood haemoglobin (OR, 0.17; 95% CI, 0.05–0.60). Conclusion Dietary iron intake was nonlinearly negatively associated with the prevalence of DR and VTDR, showing protective effect against retinopathy of medium-high iron intake in T2D patients. Such associations significantly vary by multiple factors such as age, ethnicity, obesity and glycaemic control. |
| format | Article |
| id | doaj-art-908b3495c8a34d9f90a1dde13887f746 |
| institution | OA Journals |
| issn | 1472-6823 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
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| series | BMC Endocrine Disorders |
| spelling | doaj-art-908b3495c8a34d9f90a1dde13887f7462025-08-20T02:17:47ZengBMCBMC Endocrine Disorders1472-68232025-04-0125111110.1186/s12902-025-01926-zDietary iron intake is nonlinearly associated with the risk of diabetic retinopathy in adults with type 2 diabetesXiaoyun Chen0Yihang Fu1Hongyu Si2Wenfei Li3Weimin Yang4Wei Xiao5State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Centre for Ocular Diseases, Sun Yat- Sen UniversityState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Centre for Ocular Diseases, Sun Yat- Sen UniversityState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Centre for Ocular Diseases, Sun Yat- Sen UniversityState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Centre for Ocular Diseases, Sun Yat- Sen UniversityState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Centre for Ocular Diseases, Sun Yat- Sen UniversityState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Centre for Ocular Diseases, Sun Yat- Sen UniversityAbstract Objective To elucidate the association between dietary iron intake and diabetic retinopathy (DR) in type 2 diabetes (T2D) patients. Methods Participants from the National Health and Nutrition Examination Survey (NHANES) 2005–2008 aged over 40 years with T2D were included. Dietary iron intake was estimated from standardised questionnaires. The presence of DR and vision-threatening DR (VTDR) was determined through retinal imaging. We used logistic regression to assess the relationship between iron intake and DR, and restricted cubic splines to reveal nonlinear links. Results The study enrolled 1172 T2D adults. We found significant nonlinear associations between dietary iron intake and DR among females (P = 0.023), but not in males (P = 0.490). Compared with the lowest quartile of iron intake, the third quartile (13.2–18.1 mg/d) yielded significantly lower odds of developing DR (odds ratio [OR], 0.59; 95% CI, 0.39–0.90) and VTDR (OR, 0.42; 95% CI, 0.19–0.94). Stratified logistic analyses showed that medium-high iron intake was associated with lower risks of DR in females (OR, 0.44; 95% CI, 0.24–0.81), non-Hispanic Blacks (OR, 0.38; 95% CI, 0.17–0.85), and individuals with obesity (OR, 0.45; 95% CI, 0.25–0.82), high HbA1c (OR, 0.56; 95% CI, 0.34–0.93), long diabetes duration (OR, 0.40; 95% CI, 0.21–0.76) or low blood haemoglobin (OR, 0.17; 95% CI, 0.05–0.60). Conclusion Dietary iron intake was nonlinearly negatively associated with the prevalence of DR and VTDR, showing protective effect against retinopathy of medium-high iron intake in T2D patients. Such associations significantly vary by multiple factors such as age, ethnicity, obesity and glycaemic control.https://doi.org/10.1186/s12902-025-01926-zDiabetic retinopathyVision-threatening diabetic retinopathyDietary iron intakeNHANES |
| spellingShingle | Xiaoyun Chen Yihang Fu Hongyu Si Wenfei Li Weimin Yang Wei Xiao Dietary iron intake is nonlinearly associated with the risk of diabetic retinopathy in adults with type 2 diabetes BMC Endocrine Disorders Diabetic retinopathy Vision-threatening diabetic retinopathy Dietary iron intake NHANES |
| title | Dietary iron intake is nonlinearly associated with the risk of diabetic retinopathy in adults with type 2 diabetes |
| title_full | Dietary iron intake is nonlinearly associated with the risk of diabetic retinopathy in adults with type 2 diabetes |
| title_fullStr | Dietary iron intake is nonlinearly associated with the risk of diabetic retinopathy in adults with type 2 diabetes |
| title_full_unstemmed | Dietary iron intake is nonlinearly associated with the risk of diabetic retinopathy in adults with type 2 diabetes |
| title_short | Dietary iron intake is nonlinearly associated with the risk of diabetic retinopathy in adults with type 2 diabetes |
| title_sort | dietary iron intake is nonlinearly associated with the risk of diabetic retinopathy in adults with type 2 diabetes |
| topic | Diabetic retinopathy Vision-threatening diabetic retinopathy Dietary iron intake NHANES |
| url | https://doi.org/10.1186/s12902-025-01926-z |
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