Abstract
Objective: This study aimed to explore the association between body mass index (BMI), cholesterol levels, and the severity of diabetic retinopathy (DR) among patients with type 2 diabetes mellitus (T2DM) at Qassim University Hospital, Saudi Arabia.
Methods: A retrospective cross-sectional study was conducted on 399 adult patients with T2DM. Data on demographics, clinical parameters (BMI and total cholesterol), diabetes duration, and DR grading were extracted from electronic medical records. DR was categorized into five stages, ranging from no DR to proliferative DR.
Results: Of the 399 patients, 28.6% had some degree of DR. No significant associations were found between DR and BMI (p-value = 0.526) or total cholesterol (p-value = 0.188). Patients with DR were significantly older (p < 0.001) and had a longer duration of diabetes (p < 0.001) compared to those without DR. Ordinal and binary logistic regression models confirmed that diabetes duration was the strongest predictor of DR presence and severity (OR = 1.102 and OR = 1.10, respectively; p < 0.001), while BMI and total cholesterol were not statistically significant predictors.
Conclusion: The study found no significant association between BMI or total cholesterol levels and DR. Instead, duration of diabetes was identified as the most significant predictor of DR. These findings highlighted the importance of long-term glycemic control and early intervention in diabetes management to mitigate the risk of retinopathy.

Key words: Diabetic retinopathy, type 2 diabetes mellitus, body mass index, cholesterol, Saudi Arabia