Journal List > J Korean Ophthalmol Soc > v.57(2) > 1010507

J Korean Ophthalmol Soc. 2016 Feb;57(2):276-282. Korean.
Published online February 16, 2016.  https://doi.org/10.3341/jkos.2016.57.2.276
©2016 The Korean Ophthalmological Society
Association between Grapes Intake and Diabetic Retinopathy: Inhibitory Effect of Resveratol on Diabetic Retinopathy
Bo Young Lee, MD, Donghyun Jee, MD, PhD, and Epidemiology Survey Committee of the Korean Ophthalmology Society
Department of Ophthalmology and Visual Science, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.

Address reprint requests to Donghyun Jee, MD, PhD. Department of Ophthalmology, The Catholic University of Korea St. Vincent's Hospital, #93 Jungbu-daero, Paldal-gu, Suwon 16247, Korea. Tel: 82-31-249-7343, Fax: 82-31-249-6225, Email: donghyunjee@catholic.ac.kr
Received November 26, 2015; Revised December 16, 2015; Accepted January 19, 2016.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

Purpose

To evaluate the association between grape intake and diabetic retinopathy.

Methods

A population-based cross-sectional study using a nation-wide, stratified, multistage, clustered sampling method included 1,555 subjects aged ≥30 years who participated in the Korean National Health and Nutritional Examination Survey 2008-2011. All participants performed standardized interviews, food frequency questionnaires (FFQ), and comprehensive ophthalmic examinations. Grape intake was evaluated by an FFQ using 10 intervals of average frequency of grape intake during the past year. Diabetic retinopathy (DR) was evaluated by 7 standard retinal fundus photographs after pharmacological pupil dilatation. DR was classified as any DR, proliferative DR, or vision-threatening DR by the modified Air House classification system.

Results

The prevalence of diabetes was 16.9 ± 1.2%. As the grape intake frequency increases in FFQ, the odds ratio (OR) for any DR, proliferative DR, and vision-threatening DR were 0.86 (95% confidence interval [CI], 0.75-0.98), 0.65 (95% CI, 0.48-0.88), and 0.77 (95% CI, 0.60-0.99) respectively. Compared to the group with a grape intake of less than once per month, the OR for any DR, proliferative DR, and vision-threatening DR in the group with a grape intake of more than 2-3 times per month were 0.54 (95% CI 0.33-0.89), 0.25 (95% CI 0.07-0.81), 0.36 (95% CI 0.13-0.95), respectively.

Conclusions

The intake of grapes was inversely associated with the prevalence of DR.

Keywords: Diabetic retinopathy; Grape; Korea National Health and Nutritional Examination Survey; Resveratrol

Figures


Figure 1
Flow diagram presenting the selection of study participants. KNHANES = Korea National Health and Nutritional Examination Survey.
Click for larger image

Tables


Table 1
Demographic and clinical characteristics, according to DR status, as reported in the Korean National Health and Nutrition Examination Survey 2008-2011
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Table 2
Prevalence of DR according to the frequency of grape intake in a representative Korean population
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Table 3
Multiple logistic regression analysis between intake of grapes (continuous variable) and any DR, PDR, and VTDR in a representative Korean population
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Table 4
Multiple logistic regression analysis between the quartile intake of grapes and any DR, PDR, and VTDR in a representative Korean population
Click for larger image

Notes

The authors wish to acknowledge the financial support of the St.Vincent's Hospital, Research Institute of Medical Science (SVHR-2012-12).

References
1. Klein BE. Overview of epidemiologic studies of diabetic retinopathy. Ophthalmic epidemiol 2007;14:179–183.
2. Aiello LP, Gardner TW, King GL, et al. Diabetic retinopathy. Diabetes Care 1998;21:143–156.
3. Brown MM, Brown GC, Sharma S, Shah G. Utility values and diabetic retinopathy. Am J Ophthalmol 1999;128:324–330.
4. Wong TY, Klein R, Islam FM, et al. Diabetic retinopathy in a multi-ethnic cohort in the United States. Am J Ophthalmol 2006;141:446–455.
5. Williams R, Airey M, Baxter H, et al. Epidemiology of diabetic retinopathy and macular oedema: a systematic review. Eye (Lond) 2004;18:963–983.
6. Kempen JH, O'Colmain B, Leske MC, et al. The prevalence of diabetic retinopathy among adults in the United States. Arch Ophthalmol 2004;122:552–563.
7. Yau JW, Rogers SL, Kawasaki R, et al. Global prevalence and major risk factors of diabetic retinopathy. Diabetes Care 2012;35:556–564.
8. Jee D, Lee WK, Kang S. Prevalence and risk factors for diabetic retinopathy: the Korea National Health and Nutrition Examination Survey 2008-2011. Invest Ophthalmol Vis Sci 2013;54:6827–6833.
9. Jee D, Han Kd, Kim EC. Inverse association between high blood 25-hydroxyvitamin D levels and diabetic retinopathy in a representative Korean population. PLoS One 2014;9:e115199.
10. Ghadiri Soufi F, Arbabi-Aval E, Rezaei Kanavi M, Ahmadieh H. Anti-inflammatory properties of resveratrol in the retinas of type 2 diabetic rats. Clin Exp Pharmacol Physiol 2015;42:63–68.
11. Losso JN, Truax RE, Richard G. Trans-resveratrol inhibits hyperglycemia-induced inflammation and connexin downregulation in retinal pigment epithelial cells. J Agric Food Chem 2010;58:8246–8252.
12. Kim YH, Kim YS, Roh GS, et al. Resveratrol blocks diabetes-induced early vascular lesions and vascular endothelial growth factor induction in mouse retinas. Acta Ophthalmol 2012;90:e31–e37.
13. Yar AS, Menevse S, Dogan I, et al. Investigation of ocular neovascularization-related genes and oxidative stress in diabetic rat eye tissues after resveratrol treatment. J Med Food 2012;15:391–398.
14. Soufi FG, Mohammad-Nejad D, Ahmadieh H. Resveratrol improves diabetic retinopathy possibly through oxidative stress - nuclear factor kB - apoptosis pathway. Pharmacol Rep 2012;64:1505–1514.
15. Rokicki D, Zdanowski R, Lewicki S, et al. Inhibition of proliferation, migration and invasiveness of endothelial murine cells culture induced by resveratrol. Cent Eur J Immunol 2014;39:449–454.
16. Liu XQ, Wu BJ, Pan WH, et al. Resveratrol mitigates rat retinal ischemic injury: the roles of matrix metalloproteinase-9, inducible nitric oxide, and heme oxygenase-1. J Ocul Pharmacol Ther 2013;29:33–40.
17. Bola C, Bartlett H, Eperjesi F. Resveratrol and the eye: activity and molecular mechanisms. Graefes Arch Clin Exp Ophthalmol 2014;252:699–713.
18. Semba RD, Ferrucci L, Bartali B, et al. Resveratrol levels and all-cause mortality in older community-dwelling adults. JAMA Intern Med 2014;174:1077–1084.
19. Park HA. The Korea national health and nutrition examination survey as a primary data source. Korean J Fam Med 2013;34:79.
20. Kim Y, Park S, Kim NS, Lee BK. Inappropriate survey design analysis of the Korean National Health and Nutrition Examination Survey may produce biased results. J Prev Med Public Health 2013;46:96–104.
21. Rim HT, Park SY, Yoon JS. Hormone replacement therapy and eye diseases: KNHANES IV. J Korean Ophthalmol Soc 2012;53:1445–1450.
22. Lim HT, Choi KS. Factors associated with screening for diabetic retinopathy in diabetic patients aged > or = 40 years using the KNHANES IV. J Korean Ophthalmol Soc 2012;53:516–521.
23. Diabetic retinopathy study. Report Number 6. Design, methods, and baseline results. Report Number 7. A modification of the Airlie House classification of diabetic retinopathy. Prepared by the Diabetic Retinopathy. Invest Ophthalmol Vis Sci 1981;21(1 Pt 2):1–226.
24. Willett WC, Sampson L, Stampfer MJ, et al. Reproducibility and validity of a semiquantitative food frequency questionnaire. Am J Epidemiol 1985;122:51–65.
25. Kim SJ, Choi MK. Factors Associated with Fruit and Vegetable Consumption of Subjects Having a History of Stroke: Using 5th Korea National Health and Nutrition Examination Survey (2010, 2011). Korean J Community Nutr 2014;19:468–478.
26. Scanlon PH, Aldington SJ, Stratton IM. Epidemiological issues in diabetic retinopathy. Middle East Afr J Ophthalmol 2013;20:293–300.
27. Marmot MG, Rose G, Shipley MJ, Thomas BJ. Alcohol and mortality: a U-shaped curve. Lancet 1981;1(8220 Pt 1):580–583.
28. Shaper AG, Wannamethee G, Walker M. Alcohol and mortality in British men: explaining the U-shaped curve. Lancet 1988;2:1267–1273.
29. Biagi M, Bertelli AA. Wine, alcohol and pills: What future for the French paradox? Life Sci 2015;131:19–22.
30. Wollin SD, Jones PJ. Alcohol, red wine and cardiovascular disease. J Nutr 2001;131:1401–1404.
31. Guerrero RF, Garcia-Parrilla MC, Puertas B, Cantos-Villar E. Wine, resveratrol and health: a review. Nat Prod Commun 2009;4:635–658.
32. Pendurthi UR, Williams JT, Rao LV. Resveratrol, a polyphenolic compound found in wine, inhibits tissue factor expression in vascular cells: a possible mechanism for the cardiovascular benefits associated with moderate consumption of wine. Arterioscler Thromb Vasc Biol 1999;19:419–426.
33. Stervbo U, Vang O, Bonnesen C. A review of the content of the putative chemopreventive phytoalexin resveratrol in red wine. Food Chem 2007;101:449–457.
34. Romero-Pérez AI, Lamuela-Raventós RM, Andrés-Lacueva C, de la Torre-Boronat MC. Method for the quantitative extraction of resveratrol and piceid isomers in grape berry skins. Effect of powdery mildew on the stilbene content. J Agric Food Chem 2001;49:210–215.
35. Press SJ, Wilson S. Choosing between logistic regression and discriminant analysis. J Am Stat Assoc 1978;73:699–705.