Association of serum lipids with diabetic retinopathy in Urban South Indians-the Chennai Urban Rural epidemiology study (CURES) Eye Study - 2

Abstract

Aims: To study the association of serum lipids with diabetic retinopathy (DR) in Type 2 diabetic subjects. Methods: Type 2 diabetic subjects (n = 1736) were randomly selected from the Chennai Urban Rural Epidemiology Study (CURES), which was carried out on a representative population of Chennai in South India. DR was diagnosed by retinal colour photography and classified according to the Early Treatment Diabetic Retinopathy Study (ETDRS) grading system. Classification of lipid abnormalities was done according to the National Cholesterol Education Programme-Adult Treatment Panel III (NCEP-ATP III) Guidelines. Results The mean serum cholesterol (P = 0.024), serum triglycerides (P = 0.017) and non-high-density lipoprotein (HDL)-cholesterol (P = 0.025) concentrations were higher in subjects with DR compared with those without DR. Multiple logistic regression analysis revealed that after adjusting for age, gender, duration of diabetes, total cholesterol Standardised regression estimate (SRE) = 1.178, 95% confidence interval (CI) 1.042, 1.331, P = 0.014), non-HDL-cholesterol (SRE = 1.169, 95% CI 1.040, 1.313, P = 0.012) and serum triglycerides (SRE = 1.292, 95% CI 1.136, 1.467, P = 0.001) were associated with DR and non-HDL-cholesterol (SRE = 1.264, 95% CI 1.000, 1.592, P = 0.045) and low-density lipoprotein (LDL)-cholesterol (SRE = 1.453, 95% CI 1.107, 1.896, P = 0.005) with diabetic macular oedema (DME). After adjusting for HbA_1c and body mass index, only triglycerides maintained a significant association with DR (SRE = 1.137, 95% CI 1.000, 1.291, P = 0.007) and LDL-cholesterol with macular oedema (SRE = 1.358, 95% CI 1.034, 1.774, P = 0.026). Conclusions: There is a significant association of serum triglycerides with DR and LDL-cholesterol with DME.