Association between daily low-quality carbohydrate intake and diabetic retinopathy in NHANES 2005-2008

Background: Diabetic retinopathy is a common chronic complication of diabetes and the main reason for blindness. Carbohydrate intake is an essential component of daily dietary intake. The relationship between low-quality carbohydrate intake and diabetic retinopathy in diabetes has rarely been discussed. The primary purpose of this study was to explore the association between daily low-quality carbohydrate intake and diabetic retinopathy in individuals with diabetes. Method: The study was a cross-sectional study of diabetics aged 40 years and older conducted within the National Health and Nutrition Examination Survey (NHANES) from 2005–2008. Diabetic retinopathy was diagnosed based on an ophthalmic digital imaging system. The daily low-quality carbohydrate intake was assessed according to a 24-hour dietary recall. The independent relationship between daily low-quality carbohydrate intake and diabetic retinopathy was evaluated with a weighted logistic regression model. Sensitivity analysis was performed by weighted subgroup analysis and weighted restricted cubic spline regression analysis. Results: After adjusting for confounders, daily low-quality carbohydrate intake and diabetic retinopathy were negatively associated (OR = 0.982; 95%CI, 0.964–0.999). Higher quartiles of daily low-quality carbohydrate intake were associated with a lower incidence of diabetic retinopathy compared to lower quartiles (Q3 vs Q1: OR = 0.658; 95%CI, 0.444–0.976). The weighted restricted cubic spline regression analysis demonstrated that there was no nonlinear relationship between daily low-quality carbohydrate intake and diabetic retinopathy. Subgroup analysis and interaction tests showed no significant dependence of age, race, family poverty income ratio, alcohol use, hypertension, urinary albumin creatinine ratio, total daily carbohydrate intake, or triglycerides on this negative correlation( p for interaction＞0.05). Conclusion: Our findings indicated that there was a negative correlation between daily low-quality carbohydrate intake and DR among diabetic patients aged 40 years or older in the United States. Further research should focus on exploring the specific mechanisms underlying the link between low-quality carbohydrate and DR, and the impact of dietary patterns on diabetic retinopathy requires validation in large-scale prospective studies.