The Associations of Dietary Intake of Polyunsaturated Fatty Acids With Diabetic Retinopathy in Well-Controlled Diabetes

PURPOSE. To assess the associations between dietary intake of polyunsaturated fatty acids (PUFAs) and diabetic retinopathy (DR). METHODS. This was a cross-sectional study of 379 patients (median age: 66.0 years) with diabetes attending a diabetes eye clinic. Daily fatty acid intake was assessed by using a validated Food Frequency Questionnaire and adjusted for energy intake. Diabetic retinopathy was graded from fundus photographs as no DR, nonproliferative DR, or proliferative DR. Patients were categorized as well-controlled diabetes'' (n = 123) and poorly controlled diabetes'' (n = 256), defined as glycated hemoglobin (HbA1c) level < 7.0% or >= 7.0%, respectively. RESULTS. There were no associations between any fatty acid intake and DR. However, among patients with well-controlled diabetes, increasing daily intake of PUFAs was associated with a reduced likelihood of the presence (odds ratio [OR]: 0.18; 95% confidence interval [CI]: 0.06-0.59) and severity of DR after adjusting for age, sex, HbA1c, mean arterial blood pressure, and duration of diabetes. Moreover, an increased saturated fatty acid (SFA) intake was associated with increased likelihood of the presence (OR: 2.37; 95% CI: 1.15-4.88) and severity of DR. No association was found among those with poorly controlled diabetes. CONCLUSIONS. Increasing PUFA intake was associated with a reduced likelihood of the presence and severity of DR in well-controlled diabetes, whereas increasing SFA intake was associated with an increased likelihood of the presence and severity of DR. Further studies to confirm this observation are warranted to elucidate the underlying mechanisms and potential role of dietary PUFA and SFA intake in the management of DR.