Oxidative Stress and Diabetic Retinopathy: Evidence from Epidemiological Studies

Abstract

Abstract Background Previous studies have suggested oxidative stress may play a key role in the pathogenesis of diabetic retinopathy, while evidence from observational studies directly linking oxidative biomarkers to clinically relevant outcomes has been limited. This study aims to investigate the association between an integrated oxidative balance score (OBS) and risk as well as severity of diabetic retinopathy.Methods National Health and Nutrition Examination Survey (NHANES) participants between 2005–2008 were included and the weighted logistic regression model based on digital imaging of the retina was utilized to investigate the association between OBS and retinopathy. The multifactorial Cox regression model was developed to explore the correlation between OBS and all-cause mortality among individuals with diabetic retinopathy.Results In the adjusted multifactorial logistic regression model, participants in the top OBS quartile demonstrated a 25% lower risk of diabetic retinopathy compared to those in the bottom quartile (OR 0.75, 95%CI 0.57–0.99, P = 0.041). In the multifactorial Cox regression model, among those with diabetic retinopathy in the top OBS quartile exhibited a 51% lower risk of mortality compared to those in the bottom quartile (HR 0.49, 95%CI 0.32–0.74, P < 0.001).Conclusion Our study suggests that higher cumulative antioxidant exposure assessed by OBS is associated with a reduced risk and severity of diabetic retinopathy in U.S. adults.