Asian American/Pacific Islander paradox in diabetic retinopathy: findings from the Behavioral Risk Factor Surveillance System, 2006-2008.

Abstract

OBJECTIVES: To compare the self-reported prevalence of diabetic retinopathy (DR) between Asian Americans/Pacific Islanders (AAPIs) and Whites in the United States. METHODS: We analyzed data from 70,209 adults aged > or =18 years with diabetes derived from the 2006-2008 Behavioral Risk Factor Surveillance System (BRFSS), including 1,499 AAPIs and 68,710 White individuals. RESULTS: Compared with Whites with diabetes, AAPIs with diabetes had higher socioeconomic status, fewer risk factors (eg, smoking) and coexisting chronic diseases (eg, cardiovascular disease [CVD]). Diabetes duration and percentage of persons using insulin were similar between the 2 populations. However, AAPIs had a much higher prevalence of DR (27.6%) than Whites (18.2%) (P<.001). Comparing AAPIs to Whites, the age- and gender-adjusted odds ratio of DR was 1.97 (1.48-2.62). The adjusted odds ratio was 2.21 (1.63-3.00) after adjustment for sociodemographic (education and marital status), chronic conditions (CVD and smoking), severity of diabetes and diabetes care (age of diabetes onset, frequency of self-checking blood sugar, and frequency of dilated eye exam). CONCLUSIONS: Despite their favorable socio- and health-related profiles, AAPIs had significantly higher prevalence of DR compared with Whites.