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Influence of serum lipids on the incidence and progression of diabetic retinopathy and macular oedema: Sankara Nethralaya Diabetic Retinopathy Epidemiology And Molecular genetics Study‐II
Author(s) -
Srinivasan Sangeetha,
Raman Rajiv,
Kulothungan Vaitheeswaran,
Swaminathan Gayathri,
Sharma Tarun
Publication year - 2017
Publication title -
clinical and experimental ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.3
H-Index - 74
eISSN - 1442-9071
pISSN - 1442-6404
DOI - 10.1111/ceo.12990
Subject(s) - medicine , diabetic retinopathy , retinopathy , odds ratio , incidence (geometry) , diabetes mellitus , confidence interval , population , ophthalmology , endocrinology , physics , environmental health , optics
Importance The importance of lipids on incidence and progression of diabetic retinopathy has not been studied in the Indian population. Background To elucidate the influence of serum lipid control on the incidence and progression of diabetic retinopathy and diabetic macular oedema in subjects with type 2 diabetes. Design Population‐based longitudinal observational study in a hospital setting. Participants Eight hundred ninety subjects were examined at baseline and follow‐up. Methods Diabetic retinopathy was graded per Modified Early Treatment Diabetic Retinopathy Study scales; 45°, 4‐field dilated stereoscopic digital photography was performed with an additional 30°, 7‐field for those who had retinopathy. Macular oedema was evaluated per Proposed International Clinical Diabetic Retinopathy and Diabetic Macular Oedema Disease Severity Scales. Main Outcome Measures Association of serum lipids and incidence and progression of diabetic retinopathy. Results Poor control of total cholesterol was associated with the incidence of sight‐threatening retinopathy (odds ratio = 7.2 [95% confidence interval: 1.5–34.3], P = 0.012) and macular oedema (odds ratio = 5.5 [95% confidence interval: 1.4–27.4], P = 0.037) after adjusting for potential confounders. Poor control of triglycerides was associated with progression to proliferative diabetic retinopathy (odds ratio = 3.2 [95% confidence interval: 1.1–10.5], P = 0.048). Risk for incident macular oedema ( P = 0.041) and progression to proliferative diabetic retinopathy ( P = 0.028) was greater when all lipid types were abnormal. Conclusions and Relevance Poor control of lipids is a risk factor for incidence of and progression to late stages of retinopathy. Abnormal levels of all lipid types are associated with risk of incident macular oedema and progression to proliferative diabetic retinopathy.