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16-04-2024 | Diabetic Retinopathy | Original Article

Correlation between omega-3 intake and the incidence of diabetic retinopathy based on NHANES from 2005 to 2008

Authors: Jingyu Zhang, Huangdong Li, Qian Deng, Amy Michelle Huang, Wangjian Qiu, Li Wang, Zheng Xiang, Ruiming Yang, Jiamian Liang, Zhiping Liu

Published in: Acta Diabetologica

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Abstract

Aims

To identify correlations between omega-3 intake and incidence of diabetic retinopathy (DR).

Methods

This was a cross-sectional study using data from participants over age 40 in the National Health and Nutrition Examination Survey (NHANES) 2005–2008. Metrics included participants’ intake of omega-3 fatty acids, specifically three types of representative polyunsaturated fatty acids, DR prevalence, and demographic characteristics. Multiple logistic regression models were used to assess the relationship between omega-3 intake and DR.

Results

Of the 1243 participants included in this study, omega-3 intake was lower in patients with DR relative to those without DR. Of the three polyunsaturated fatty acids within the omega-3 fatty acid family that we focused on, participants without DR consumed more docosapentaenoic acid (DPA) and docosahexaenoic acid (DHA) than those with DR. In contrast, there was no significant difference in the intake of eicosapentaenoic acid (EPA). Higher omega-3 intake was associated with a decreased risk of DR. In a crude model, the odds ratio (OR) was 0.548 (95% CI 0.315, 0.951; p = 0.033). In the fully adjusted model of omega-3 (model II), the adjusted OR was 0.525 (95% CI 0.306, 0.901; p = 0.021). DPA and DHA were also associated with a decreased risk of DR. In the full adjustment model (model II) of DPA and DHA, the adjusted ORs were 0.0002 (95% CI 0.000, 0.166; p = 0.014) and 0.293 (95% CI 0.105, 0.819; p = 0.020). Subgroup analysis showed that the protective effect of omega-3 against DR was more significant in younger patients (p value = 0.015).

Conclusions

In this cross-sectional study of the U.S. general population, we found that increased intake of omega-3 and its components, specifically DPA and DHA were negatively associated with DR incidence. This suggests that omega-3 may be a potential protective factor for DR and may help to prevent or delay the onset and progression of DR.
Literature
1.
go back to reference Khalaji A, Behnoush AH, Saeedian B, Khanmohammadi S, Shokri Varniab Z, Peiman S (2023) Endocan in prediabetes, diabetes, and diabetes-related complications: a systematic review and meta-analysis. Diabetol Metab Syndr 15:102PubMedPubMedCentralCrossRef Khalaji A, Behnoush AH, Saeedian B, Khanmohammadi S, Shokri Varniab Z, Peiman S (2023) Endocan in prediabetes, diabetes, and diabetes-related complications: a systematic review and meta-analysis. Diabetol Metab Syndr 15:102PubMedPubMedCentralCrossRef
2.
go back to reference Yorek MA (2018) The potential role of fatty acids in treating diabetic neuropathy. Curr Diabetes Rep 18:86CrossRef Yorek MA (2018) The potential role of fatty acids in treating diabetic neuropathy. Curr Diabetes Rep 18:86CrossRef
3.
go back to reference Li W, Xing Q, Liu Z, Liu R, Hu Y, Yan Q et al (2023) The signaling pathways of traditional Chinese medicine in treating diabetic retinopathy. Front Pharmacol 14:1165649PubMedPubMedCentralCrossRef Li W, Xing Q, Liu Z, Liu R, Hu Y, Yan Q et al (2023) The signaling pathways of traditional Chinese medicine in treating diabetic retinopathy. Front Pharmacol 14:1165649PubMedPubMedCentralCrossRef
5.
go back to reference Gorusupudi A, Chang FY, Nelson K, Hageman GS, Bernstein PS (2019) n-3 PUFA supplementation alters retinal very-long-chain-PUFA levels and ratios in diabetic animal models. Mol Nutr Food Res 63:e1801058PubMedPubMedCentralCrossRef Gorusupudi A, Chang FY, Nelson K, Hageman GS, Bernstein PS (2019) n-3 PUFA supplementation alters retinal very-long-chain-PUFA levels and ratios in diabetic animal models. Mol Nutr Food Res 63:e1801058PubMedPubMedCentralCrossRef
6.
go back to reference Lafuente M, Ortín L, Argente M, Guindo JL, López-Bernal MD, López-Román FJ et al (2019) Three-year outcomes in a randomized single-blind controlled trial of intravitreal ranibizumab and oral supplementation with docosahexaenoic acid and antioxidants for diabetic macular edema. Retina 39:1083–1090PubMedCrossRef Lafuente M, Ortín L, Argente M, Guindo JL, López-Bernal MD, López-Román FJ et al (2019) Three-year outcomes in a randomized single-blind controlled trial of intravitreal ranibizumab and oral supplementation with docosahexaenoic acid and antioxidants for diabetic macular edema. Retina 39:1083–1090PubMedCrossRef
7.
go back to reference Rundblad A, Sandoval V, Holven KB, Ordovás JM, Ulven SM (2023) Omega-3 fatty acids and individual variability in plasma triglyceride response: a mini-review. Redox Biol 63:102730PubMedPubMedCentralCrossRef Rundblad A, Sandoval V, Holven KB, Ordovás JM, Ulven SM (2023) Omega-3 fatty acids and individual variability in plasma triglyceride response: a mini-review. Redox Biol 63:102730PubMedPubMedCentralCrossRef
8.
go back to reference Huang L, Zhang F, Xu P, Zhou Y, Liu Y, Zhang H et al (2023) Effect of omega-3 polyunsaturated fatty acids on cardiovascular outcomes in patients with diabetes: a meta-analysis of randomized controlled trials. Adv Nutr 14:629–636PubMedPubMedCentralCrossRef Huang L, Zhang F, Xu P, Zhou Y, Liu Y, Zhang H et al (2023) Effect of omega-3 polyunsaturated fatty acids on cardiovascular outcomes in patients with diabetes: a meta-analysis of randomized controlled trials. Adv Nutr 14:629–636PubMedPubMedCentralCrossRef
10.
go back to reference Lafuente M, Rodríguez González-Herrero ME, Romeo Villadóniga S, Domingo JC (2021) Antioxidant activity and neuroprotective role of docosahexaenoic acid (DHA) supplementation in eye diseases that can lead to blindness: a narrative review. Antioxidants 10:386PubMedPubMedCentralCrossRef Lafuente M, Rodríguez González-Herrero ME, Romeo Villadóniga S, Domingo JC (2021) Antioxidant activity and neuroprotective role of docosahexaenoic acid (DHA) supplementation in eye diseases that can lead to blindness: a narrative review. Antioxidants 10:386PubMedPubMedCentralCrossRef
11.
go back to reference Sanz-González S, García-Medina J, Zanón-Moreno V, López-Gálvez M, Galarreta-Mira D, Duarte L et al (2020) Clinical and molecular-genetic insights into the role of oxidative stress in diabetic retinopathy: antioxidant strategies and future avenues. Antioxidants 9:1101PubMedPubMedCentralCrossRef Sanz-González S, García-Medina J, Zanón-Moreno V, López-Gálvez M, Galarreta-Mira D, Duarte L et al (2020) Clinical and molecular-genetic insights into the role of oxidative stress in diabetic retinopathy: antioxidant strategies and future avenues. Antioxidants 9:1101PubMedPubMedCentralCrossRef
12.
go back to reference Sapieha P, Chen J, Stahl A, Seaward MR, Favazza TL, Juan AM et al (2012) Omega-3 polyunsaturated fatty acids preserve retinal function in type 2 diabetic mice. Nutr Diabetes 2:e36PubMedPubMedCentralCrossRef Sapieha P, Chen J, Stahl A, Seaward MR, Favazza TL, Juan AM et al (2012) Omega-3 polyunsaturated fatty acids preserve retinal function in type 2 diabetic mice. Nutr Diabetes 2:e36PubMedPubMedCentralCrossRef
13.
go back to reference Sala-Vila A, Díaz-López A, Valls-Pedret C, Cofán M, García-Layana A, Lamuela-Raventós R et al (2016) Dietary marine ω-3 fatty acids and incident sight-threatening retinopathy in middle-aged and older individuals with type 2 diabetes: prospective investigation from the PREDIMED trial. Jama Ophthalmol 134:1142–1149PubMedCrossRef Sala-Vila A, Díaz-López A, Valls-Pedret C, Cofán M, García-Layana A, Lamuela-Raventós R et al (2016) Dietary marine ω-3 fatty acids and incident sight-threatening retinopathy in middle-aged and older individuals with type 2 diabetes: prospective investigation from the PREDIMED trial. Jama Ophthalmol 134:1142–1149PubMedCrossRef
14.
go back to reference Zhao S, Jin D, Wang S, Xu Y, Li H, Chang Y et al (2021) Serum ω-6/ω-3 polyunsaturated fatty acids ratio and diabetic retinopathy: a propensity score matching based case-control study in China. EClinicalMedicine 39:101089PubMedPubMedCentralCrossRef Zhao S, Jin D, Wang S, Xu Y, Li H, Chang Y et al (2021) Serum ω-6/ω-3 polyunsaturated fatty acids ratio and diabetic retinopathy: a propensity score matching based case-control study in China. EClinicalMedicine 39:101089PubMedPubMedCentralCrossRef
15.
go back to reference Huang D, Lai S, Zhong S, Jia Y (2023) Association between serum copper, zinc, and selenium concentrations and depressive symptoms in the US adult population, NHANES (2011–2016). BMC Psychiatry 23:498PubMedPubMedCentralCrossRef Huang D, Lai S, Zhong S, Jia Y (2023) Association between serum copper, zinc, and selenium concentrations and depressive symptoms in the US adult population, NHANES (2011–2016). BMC Psychiatry 23:498PubMedPubMedCentralCrossRef
17.
go back to reference Wei C, Zhang W, Chen J, He Q, Cao L, Zhang P et al (2023) Systematic analysis between inflammation-related index and sex hormones in American adults: cross-sectional research based NHANES 2013–2016. Front Immunol 14:1175764PubMedPubMedCentralCrossRef Wei C, Zhang W, Chen J, He Q, Cao L, Zhang P et al (2023) Systematic analysis between inflammation-related index and sex hormones in American adults: cross-sectional research based NHANES 2013–2016. Front Immunol 14:1175764PubMedPubMedCentralCrossRef
18.
go back to reference Wang X, Zhang W, Huang J, Li H, Gao J (2023) The relationship between vitamin K and metabolic dysfunction-associated fatty liver disease among the United States population: national health and nutrition examination survey 2017–2018. Front Nutr 10:1086477PubMedPubMedCentralCrossRef Wang X, Zhang W, Huang J, Li H, Gao J (2023) The relationship between vitamin K and metabolic dysfunction-associated fatty liver disease among the United States population: national health and nutrition examination survey 2017–2018. Front Nutr 10:1086477PubMedPubMedCentralCrossRef
19.
go back to reference Raper N, Perloff B, Ingwersen L, Steinfeldt L, Anand J (2004) An overview of USDA’s dietary intake data system. J of food compos anal 17:545–555CrossRef Raper N, Perloff B, Ingwersen L, Steinfeldt L, Anand J (2004) An overview of USDA’s dietary intake data system. J of food compos anal 17:545–555CrossRef
20.
go back to reference Wang H, Lv Y, Ti G, Ren G (2022) Association of low-carbohydrate-diet score and cognitive performance in older adults: national health and nutrition examination survey (NHANES). Bmc Geriatr 22:983PubMedPubMedCentralCrossRef Wang H, Lv Y, Ti G, Ren G (2022) Association of low-carbohydrate-diet score and cognitive performance in older adults: national health and nutrition examination survey (NHANES). Bmc Geriatr 22:983PubMedPubMedCentralCrossRef
21.
go back to reference Xie Z, Wang L, Sun M, Wang R, Li J, Wang X et al (2023) Mediation of 10-year cardiovascular disease risk between inflammatory diet and handgrip strength: base on NHANES. Nutrients 15:918PubMedPubMedCentralCrossRef Xie Z, Wang L, Sun M, Wang R, Li J, Wang X et al (2023) Mediation of 10-year cardiovascular disease risk between inflammatory diet and handgrip strength: base on NHANES. Nutrients 15:918PubMedPubMedCentralCrossRef
22.
go back to reference Mazidi M, Katsiki N, Mikhailidis DP, Sattar N, Banach M (2019) Lower carbohydrate diets and all-cause and cause-specific mortality: a population-based cohort study and pooling of prospective studies. Eur Heart J 40:2870–2879PubMedCrossRef Mazidi M, Katsiki N, Mikhailidis DP, Sattar N, Banach M (2019) Lower carbohydrate diets and all-cause and cause-specific mortality: a population-based cohort study and pooling of prospective studies. Eur Heart J 40:2870–2879PubMedCrossRef
23.
go back to reference Grading diabetic retinopathy from stereoscopic color fundus photographs (1991)--an extension of the modified Airlie House classification. ETDRS report number 10. Early Treatment Diabetic Retinopathy Study Research Group. Ophthalmology 98: 786–806. Grading diabetic retinopathy from stereoscopic color fundus photographs (1991)--an extension of the modified Airlie House classification. ETDRS report number 10. Early Treatment Diabetic Retinopathy Study Research Group. Ophthalmology 98: 786–806.
24.
go back to reference Klein R, Klein BE, Magli YL, Brothers RJ, Meuer SM, Moss SE et al (1986). An alternative method of grading diabetic retinopathy. 93 Klein R, Klein BE, Magli YL, Brothers RJ, Meuer SM, Moss SE et al (1986). An alternative method of grading diabetic retinopathy. 93
25.
go back to reference Zhang J, Ren Z, Zhang Q, Zhang R, Zhang C, Liu J (2022) Lower hydration status increased diabetic retinopathy among middle-aged adults and older adults: results from NHANES 2005–2008. Front Public Health 10:1023747PubMedPubMedCentralCrossRef Zhang J, Ren Z, Zhang Q, Zhang R, Zhang C, Liu J (2022) Lower hydration status increased diabetic retinopathy among middle-aged adults and older adults: results from NHANES 2005–2008. Front Public Health 10:1023747PubMedPubMedCentralCrossRef
26.
go back to reference Chen Y, Chen Y (2022) Association between dietary calcium and potassium and diabetic retinopathy: a cross-sectional retrospective study. Nutrients 14:1086PubMedPubMedCentralCrossRef Chen Y, Chen Y (2022) Association between dietary calcium and potassium and diabetic retinopathy: a cross-sectional retrospective study. Nutrients 14:1086PubMedPubMedCentralCrossRef
28.
go back to reference Ahluwalia N, Dwyer J, Terry A, Moshfegh A, Johnson C (2016) Update on NHANES dietary data: focus on collection, release, analytical considerations, and uses to inform public policy. Adv nutr 7:121–34PubMedPubMedCentralCrossRef Ahluwalia N, Dwyer J, Terry A, Moshfegh A, Johnson C (2016) Update on NHANES dietary data: focus on collection, release, analytical considerations, and uses to inform public policy. Adv nutr 7:121–34PubMedPubMedCentralCrossRef
29.
go back to reference Suzumura A, Kaneko H, Funahashi Y, Takayama K, Nagaya M, Ito S et al (2020) n-3 Fatty acid and Its metabolite 18-HEPE ameliorate retinal neuronal cell dysfunction by enhancing müller BDNF in diabetic retinopathy. Diabetes 69:724–735PubMedCrossRef Suzumura A, Kaneko H, Funahashi Y, Takayama K, Nagaya M, Ito S et al (2020) n-3 Fatty acid and Its metabolite 18-HEPE ameliorate retinal neuronal cell dysfunction by enhancing müller BDNF in diabetic retinopathy. Diabetes 69:724–735PubMedCrossRef
30.
go back to reference Dátilo MN, Sant’Ana MR, Formigari GP, Rodrigues PB, de Moura LP, da Silva ASR et al (2018) Omega-3 from flaxseed oil protects obese mice against diabetic retinopathy through GPR120 receptor. Sci Rep-Uk 8:14318CrossRef Dátilo MN, Sant’Ana MR, Formigari GP, Rodrigues PB, de Moura LP, da Silva ASR et al (2018) Omega-3 from flaxseed oil protects obese mice against diabetic retinopathy through GPR120 receptor. Sci Rep-Uk 8:14318CrossRef
31.
go back to reference Díaz-López A, Babio N, Martínez-González MA, Corella D, Amor AJ, Fitó M et al (2015) Mediterranean diet, retinopathy, nephropathy, and microvascular diabetes complications: a post Hoc analysis of a randomized trial. Diabetes Care 38:2134–2141PubMedCrossRef Díaz-López A, Babio N, Martínez-González MA, Corella D, Amor AJ, Fitó M et al (2015) Mediterranean diet, retinopathy, nephropathy, and microvascular diabetes complications: a post Hoc analysis of a randomized trial. Diabetes Care 38:2134–2141PubMedCrossRef
32.
go back to reference Weir NL, Guan W, Karger AB, Klein BEK, Meuer SM, Cotch MF et al (2023) Omega-3 fatty acids are associated with decreased presence and severity of diabetic retinopathY. Retina 43:984–991PubMedCrossRef Weir NL, Guan W, Karger AB, Klein BEK, Meuer SM, Cotch MF et al (2023) Omega-3 fatty acids are associated with decreased presence and severity of diabetic retinopathY. Retina 43:984–991PubMedCrossRef
33.
go back to reference Gao X, Hong G, Zhan W, Liu T, Yan S, Deng M et al (2022) DPA promotes hBMSCs osteogenic differentiation by miR-9-5p/ERK/ALP signaling pathway. Int J Med Sci 19:1879–1887PubMedPubMedCentralCrossRef Gao X, Hong G, Zhan W, Liu T, Yan S, Deng M et al (2022) DPA promotes hBMSCs osteogenic differentiation by miR-9-5p/ERK/ALP signaling pathway. Int J Med Sci 19:1879–1887PubMedPubMedCentralCrossRef
34.
go back to reference Lu L, Li X, Lv L, Xu Y, Wu B, Huang C (2022) Associations between omega-3 fatty acids and insulin resistance and body composition in women with polycystic ovary syndrome. Front Nutr 9:1016943PubMedPubMedCentralCrossRef Lu L, Li X, Lv L, Xu Y, Wu B, Huang C (2022) Associations between omega-3 fatty acids and insulin resistance and body composition in women with polycystic ovary syndrome. Front Nutr 9:1016943PubMedPubMedCentralCrossRef
35.
go back to reference Shen J, Ma Q, Shen S, Xu G, Das UN (2013) Effect of α-linolenic acid on streptozotocin-induced diabetic retinopathy indices in vivo. Arch Med Res 44:514–520PubMedCrossRef Shen J, Ma Q, Shen S, Xu G, Das UN (2013) Effect of α-linolenic acid on streptozotocin-induced diabetic retinopathy indices in vivo. Arch Med Res 44:514–520PubMedCrossRef
36.
go back to reference Deinema LA, Vingrys AJ, Wong CY, Jackson DC, Chinnery HR, Downie LE (2017) A randomized, double-masked, placebo-controlled clinical trial of two forms of omega-3 supplements for treating dry eye disease. Ophthalmology 124:43–52PubMedCrossRef Deinema LA, Vingrys AJ, Wong CY, Jackson DC, Chinnery HR, Downie LE (2017) A randomized, double-masked, placebo-controlled clinical trial of two forms of omega-3 supplements for treating dry eye disease. Ophthalmology 124:43–52PubMedCrossRef
37.
go back to reference Kalogerou M, Kolovos P, Prokopiou E, Papagregoriou G, Deltas C, Malas S et al (2018) Omega-3 fatty acids protect retinal neurons in the DBA/2J hereditary glaucoma mouse model. Exp Eye Res 167:128–139PubMedCrossRef Kalogerou M, Kolovos P, Prokopiou E, Papagregoriou G, Deltas C, Malas S et al (2018) Omega-3 fatty acids protect retinal neurons in the DBA/2J hereditary glaucoma mouse model. Exp Eye Res 167:128–139PubMedCrossRef
38.
go back to reference Behl T, Kotwani A (2017) Omega-3 fatty acids in prevention of diabetic retinopathy. J Pharm Pharmacol 69:946–954PubMedCrossRef Behl T, Kotwani A (2017) Omega-3 fatty acids in prevention of diabetic retinopathy. J Pharm Pharmacol 69:946–954PubMedCrossRef
39.
go back to reference Cecilia O, José Alberto C, José N, Ernesto Germán C, Ana Karen L, Luis Miguel R et al (2019) Oxidative stress as the main target in diabetic retinopathy pathophysiology. J Diabetes Res 2019:8562408PubMedPubMedCentralCrossRef Cecilia O, José Alberto C, José N, Ernesto Germán C, Ana Karen L, Luis Miguel R et al (2019) Oxidative stress as the main target in diabetic retinopathy pathophysiology. J Diabetes Res 2019:8562408PubMedPubMedCentralCrossRef
40.
go back to reference Eynard AR, Repossi G (2019) Role of omega3 polyunsaturated fatty acids in diabetic retinopathy: a morphological and metabolically cross talk among blood retina barriers damage, autoimmunity and chronic inflammation. Lipids Health Dis 18:114PubMedPubMedCentralCrossRef Eynard AR, Repossi G (2019) Role of omega3 polyunsaturated fatty acids in diabetic retinopathy: a morphological and metabolically cross talk among blood retina barriers damage, autoimmunity and chronic inflammation. Lipids Health Dis 18:114PubMedPubMedCentralCrossRef
41.
go back to reference Rotstein NP, Politi LE, German OL, Girotti R (2003) Protective effect of docosahexaenoic acid on oxidative stress-induced apoptosis of retina photoreceptors. Invest Ophth Vis Sci 44:2252–2259CrossRef Rotstein NP, Politi LE, German OL, Girotti R (2003) Protective effect of docosahexaenoic acid on oxidative stress-induced apoptosis of retina photoreceptors. Invest Ophth Vis Sci 44:2252–2259CrossRef
42.
go back to reference Mahmoudabadi MMS, Rahbar AR (2014) Effect of EPA and vitamin C on superoxide dismutase, glutathione peroxidase, total antioxidant capacity and malondialdehyde in type 2 diabetic patients. Oman Med J 29:39–45PubMedPubMedCentralCrossRef Mahmoudabadi MMS, Rahbar AR (2014) Effect of EPA and vitamin C on superoxide dismutase, glutathione peroxidase, total antioxidant capacity and malondialdehyde in type 2 diabetic patients. Oman Med J 29:39–45PubMedPubMedCentralCrossRef
43.
go back to reference Saenz De Viteri M, Hernandez M, Bilbao-Malavé V, Fernandez-Robredo P, González-Zamora J, Garcia-Garcia L et al (2020) A higher proportion of eicosapentaenoic acid (EPA) when combined with docosahexaenoic acid (DHA) in omega-3 dietary supplements provides higher antioxidant effects in human retinal cells. Antioxidants 9:828PubMedPubMedCentralCrossRef Saenz De Viteri M, Hernandez M, Bilbao-Malavé V, Fernandez-Robredo P, González-Zamora J, Garcia-Garcia L et al (2020) A higher proportion of eicosapentaenoic acid (EPA) when combined with docosahexaenoic acid (DHA) in omega-3 dietary supplements provides higher antioxidant effects in human retinal cells. Antioxidants 9:828PubMedPubMedCentralCrossRef
44.
go back to reference Yazdi PG (2013) A review of the biologic and pharmacologic role of docosapentaenoic acid n-3. F1000Research 2:256PubMedCrossRef Yazdi PG (2013) A review of the biologic and pharmacologic role of docosapentaenoic acid n-3. F1000Research 2:256PubMedCrossRef
45.
go back to reference Dangi B, Obeng M, Nauroth JM, Teymourlouei M, Needham M, Raman K et al (2009) Biogenic synthesis, purification, and chemical characterization of anti-inflammatory resolvins derived from docosapentaenoic acid (DPAn-6). J Biol Chem 284:14744–14759PubMedPubMedCentralCrossRef Dangi B, Obeng M, Nauroth JM, Teymourlouei M, Needham M, Raman K et al (2009) Biogenic synthesis, purification, and chemical characterization of anti-inflammatory resolvins derived from docosapentaenoic acid (DPAn-6). J Biol Chem 284:14744–14759PubMedPubMedCentralCrossRef
46.
go back to reference Rondanelli M, Gasparri C, Riva A, Petrangolini G, Barrile GC, Cavioni A et al (2023). Diet and ideal food pyramid to prevent or support the treatment of diabetic retinopathy, age-related macular degeneration, and cataracts. 10. Rondanelli M, Gasparri C, Riva A, Petrangolini G, Barrile GC, Cavioni A et al (2023). Diet and ideal food pyramid to prevent or support the treatment of diabetic retinopathy, age-related macular degeneration, and cataracts. 10.
47.
go back to reference Yeh YK, Yen FS, Hwu CM (2023) Diet and exercise are a fundamental part of comprehensive care for type 2 diabetes. J Diabetes Invest 14:936–939CrossRef Yeh YK, Yen FS, Hwu CM (2023) Diet and exercise are a fundamental part of comprehensive care for type 2 diabetes. J Diabetes Invest 14:936–939CrossRef
48.
go back to reference Mokhtari Z, Mokhtari S, Afrasiabifar A, Hosseini N (2023) The effect of family-centered intervention on key indicators of diabetes management and control in patients with type-2 diabetes. Int J Prev Med 14:54PubMedPubMedCentral Mokhtari Z, Mokhtari S, Afrasiabifar A, Hosseini N (2023) The effect of family-centered intervention on key indicators of diabetes management and control in patients with type-2 diabetes. Int J Prev Med 14:54PubMedPubMedCentral
Metadata
Title
Correlation between omega-3 intake and the incidence of diabetic retinopathy based on NHANES from 2005 to 2008
Authors
Jingyu Zhang
Huangdong Li
Qian Deng
Amy Michelle Huang
Wangjian Qiu
Li Wang
Zheng Xiang
Ruiming Yang
Jiamian Liang
Zhiping Liu
Publication date
16-04-2024
Publisher
Springer Milan
Published in
Acta Diabetologica
Print ISSN: 0940-5429
Electronic ISSN: 1432-5233
DOI
https://doi.org/10.1007/s00592-024-02267-4
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