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Journal of Diabetes Research
Volume 2016, Article ID 3674946, 8 pages
Research Article

Lower Hemoglobin Concentration Is Associated with Retinal Ischemia and the Severity of Diabetic Retinopathy in Type 2 Diabetes

1Department of Ophthalmology, University Hospital Arnau de Vilanova, 25198 Lleida, Spain
2Department of Endocrinology and Nutrition, University Hospital Arnau de Vilanova, 25198 Lleida, Spain
3Institut de Recerca Biomedica de Lleida, University of Lleida, 25198 Lleida, Spain
4Department of Endocrinology and Nutrition, Institut d’Investigacions Biomediques August Pi Suñer, CIBER de Obesidad y Nutrición, Hospital Clinic, 08036 Barcelona, Spain
5Department of Optometry, University Hospital Arnau de Vilanova, 25198 Lleida, Spain
6Department of Endocrinology and Nutrition, CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Health Sciences Research Institute and University Hospital Germans Trias i Pujol, 08916 Badalona, Spain

Received 19 December 2015; Accepted 31 March 2016

Academic Editor: Marco Songini

Copyright © 2016 Alicia Traveset et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Aims. To assess the association of blood oxygen-transport capacity variables with the prevalence of diabetic retinopathy (DR), retinal ischemia, and macular oedema in patients with type 2 diabetes mellitus (T2DM). Methods. Cross-sectional, case-control study () with T2DM: 153 individuals with DR and 159 individuals with no DR. Participants were classified according to the severity of DR and the presence of retinal ischemia or macular oedema. Hematological variables were collected by standardized methods. Three logistic models were adjusted to ascertain the association between hematologic variables with the severity of DR and the presence of retinal ischemia or macular oedema. Results. Individuals with severe DR showed significantly lower hemoglobin, hematocrit, and erythrocyte levels compared with those with mild disease and in individuals with retinal ischemia and macular oedema compared with those without these disorders. Hemoglobin was the only factor that showed a significant inverse association with the severity of DR [beta-coefficient = −0.52,  value = 0.003] and retinal ischemia [beta-coefficient = −0.49,  value = 0.001]. Lower erythrocyte level showed a marginally significant association with macular oedema [beta-coefficient = −0.86,  value = 0.055]. Conclusions. In patients with DR, low blood oxygen-transport capacity was associated with more severe DR and the presence of retinal ischemia. Low hemoglobin levels may have a key role in the development and progression of DR.