LAUSR

Supplemental Digital Content is Available in the Text. Circulating level of omega-3 fatty acid DHA, but not EPA, was inversely associated with the presence of diabetic retinopathy, whereas DHA and EPA + DHA were inversely associated with the severity of diabetic retinopathy in a combined analysis of 1,356 diabetic participants from the MESA and GODLR cohorts. Purpose: Inflammation is associated with diabetic retinopathy development and progression, and previous studies have demonstrated that omega-3 polyunsaturated fatty acids have anti-inflammatory properties. Therefore, the goal of this study was to determine if omega-3 polyunsaturated fatty acids, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), are associated with decreased risk and severity of retinopathy in individuals with type 2 diabetes. Methods: In a combined population of 1,356 individuals with type 2 diabetes from the Multi-Ethnic Study of Atherosclerosis and Genetics of Latino Diabetic Retinopathy cohorts, odds ratios using logistic regression were determined to assess the association between polyunsaturated fatty acids and retinopathy. Results: In 1,356 participants with type 2 diabetes, individuals in the fourth quartile of DHA were 17% less likely to have retinopathy compared with the first quartile (P = 0.009, CI: 0.72–0.95). Secondary analysis revealed 38% lower severity of retinopathy in individuals in the fourth quartile compared with the first quartile of DHA (P = 0.006; CI: 0.44–0.87) and EPA + DHA (P = 0.004; CI: 0.44–0.85). No significant associations were observed between EPA and retinopathy. Conclusion: DHA is inversely associated with the presence and severity of diabetic retinopathy. Increased intake of dietary sources of DHA may provide some protection against retinopathy in individuals with type 2 diabetes and warrants more research as a preventative option.