Sex differences in risk factors for retinopathy in non-diabetic men and women: the Tromsø Eye Study.

. Purpose:  To determine the prevalence and risk factors for retinopathy in a nondiabetic population. Methods:  The study population included 5869 participants without diabetes aged 38–87 years from the Tromso Eye Study, a substudy of the population-based Tromso Study in Norway. Retinal images from both eyes were graded for retinopathy. We collected data on risk factors from self-report questionnaires, clinical examinations, laboratory measurements and case note reviews. The cross-sectional relationship between potential risk factors and retinopathy was assessed using logistic regression analysis. Results:  The overall prevalence of retinopathy was 14.8%. Men had a higher prevalence of retinopathy compared with women (15.9% versus 14.0%, p = 0.04). In men, retinopathy was associated with hypertension (odds ratio [OR], 1.59; 95% confidence interval [CI], 1.24–2.04) and HbA1c (OR per %, 1.41; 95% CI, 1.01–1.96). In women, retinopathy was associated with age (OR per 10 years, 1.32; 95% CI, 1.14–1.52), log-transformed urinary albumin excretion (OR per log unit, 1.46; 95% CI, 1.14–1.87) and hypertension (OR, 1.36; 95% CI, 1.08–1.71). In women, retinopathy was associated with very low levels of urinary albumin excretion (urinary albumin/creatinine ratio >0.43 mg/mmol). Conclusion:  This study confirms results from previous studies on the strong association between blood pressure and retinopathy. A novel finding is the sex differences in risk factors for retinopathy, suggesting a sex difference in the pathogenesis leading to retinopathy.