Cardiovascular risk profile, diabetes specific factors, and prevalent microvascular eye complications in sub-Saharan Africans with type 2 diabetes

The aim of this study is to examine the association between cardiovascular risk profile, diabetes-specific factors, and prevalent retinopathy in sub-Saharan Africans with type 2 diabetes. We enrolled 213 (41 % women) diabetic adults from the Cameroon National Obesity Center in 2008. Prevalent retinopathy was based on history and digital mydriatic retinal photography. Cardiovascular risk profile was assessed, and global absolute coronary risk was estimated with the UK Prospective Diabetes Study (UKPDS) and Framingham coronary risk equations. Logistic regressions were used to relate risk factors to prevalent retinopathy and discrimination and calibration assessed. Fifty-four patients (25.4 %) had prevalent of retinopathy. Patients with retinopathy had more often hypertension (88 vs 43 %, p = 0.003), and age at diagnosis, known duration of diabetes, blood glucose, and systolic blood pressure were associated with retinopathy. Estimated 10-year coronary risks by the Framingham and UKPDS had low discrimination for retinopathy, with C-statistic (95 % confidence interval) of 0.593 (0.504–0.682) and 0.603 (0.518–0.688), respectively. New equations developed from this sample had better discrimination and calibration, with a maximum C-statistic of 0.881 (0.828–0.933). Cardiovascular risk profile was poorly correlated with prevalent retinopathy in this population. Strategies based upon routinely assessed diabetes-related factors can improve the selection of patients at high risk of retinopathy for costly confirmatory investigations.