Body mass index and risk of diabetic retinopathy: A meta-analysis and systematic review

Diabetic retinopathy (DR) is a frequent cause of acquired blindness worldwide. Various studies have reported the effects of body mass index (BMI) on the risk of DR, but the results remain controversial. Therefore, a meta-analysis was performed to evaluate the relationship between BMI and the risk of DR. A systematic search was performed using the Cochrane Library, PubMed, and Embase databases to obtain articles published through December 2016. Articles regarding the association between BMI and the risk of DR were retrieved. The adjusted odds ratios (ORs) and their 95% confidence intervals (CIs) were included and then pooled with a random effects model. A total of 27 articles were included in this meta-analysis. When BMI was analyzed as a categorical variable, neither being overweight (OR = 0.89, 95% CI 0.75–1.07; P = .21; I(2) = 65%) nor obesity (OR = 0.97, 95% CI 0.73–1.30; P = .86) were associated with an increased risk of DR when compared with normal weight. When BMI was analyzed as a continuous variable, a higher BMI was not associated with an increased risk of DR (OR = 0.99, 95% CI 0.97–1.01; P = .25; I2 = 79%). The pooled results did not significantly change after the sensitivity analysis. Based on the current publications, neither being overweight nor obesity is associated with an increased risk of DR. Further studies should confirm these findings.