Abstract
This study aims to evaluate the association between fasting serum free fatty acids (FFAs) and diabetic retinopathy (DR) in a population of Chinese men with type 2 diabetes mellitus (T2DM). A total of 781 eligible subjects participated in this cross-sectional study. We collected clinical data and information about the patient's examination and laboratory tests. The Shapiro-Wilk test was employed to assess the normality of continuous variables. For continuous variables with non-normal distributions, the Mann-Whitney U test and the Kruskal-Wallis test was utilized for comparisons. Categorical variable comparisons were performed using the chi-square test. Logistic regression analyses and restricted cubic spline (RCS) curves were conducted to examine the association between FFAs levels and DR. FFAs levels were slightly lower in the DR group compared to the NDR group (0.35 vs. 0.41 mmol/L, p < 0.05). The logistic regression model did not identify a statistically significant linear relationship between FFAs levels and DR incidence (OR = 0.776, 95% CI: 0.308-1.955, p = 0.591). After adjusting for various confounding factors, RCS curves revealed a U-shaped relationship between FFAs and DR. This relationship was validated in subgroup analyses stratified by age, diabetes duration, BMI, and alcohol consumption status. The U-shaped curve was evident in most subgroups, indicating that both low and high levels of FFAs are associated with an increased risk of DR. IIn this study, we found a U-shaped relationship between FFAs and DR in Chinese men with T2DM. Both low and high levels of FFAs were associated with an increased risk of DR.