Association Between Increased Lipid Profiles and Risk of Diabetic Retinopathy in a Population-Based Case-Control Study

Zhenzhen Liu, Mingxi Shao, Jun Ren, Yichao Qiu, Shengjie Li, Wenjun Cao Department of Clinical Laboratory, Eye and Ear Nose Throat (ENT) Hospital, Shanghai Medical College, Fudan University, Shanghai, People’s Republic of ChinaCorrespondence: Shengjie Li; Wenjun Cao, Department of Clinical Laboratory, Eye and Ear Nose Throat (ENT) Hospital, Shanghai Medical College, Fudan University, Fenyang Road 83th, Shanghai, People’s Republic of China, Tel/Fax +86 21-64377134-2510 ; +86 21-64377134-2662, Email lishengjie6363020@163.com; wgkjyk@aliyun.comPurpose: We aimed to investigate the association between lipid profiles and diabetic retinopathy (DR).Patients and Methods: This case-control study, which was conducted between November 2019 and August 2021, comprised 309 patients with DR, 186 patients with diabetes mellitus, and 172 healthy controls. Serum cholesterol (CHOL), triglyceride (TRIG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), small dense LDL-C (SDLDL-C), apolipoprotein A (APOA), APOB, APOE and lipoprotein (a)(LPA) levels were assessed. Patients were divided into two groups according to median age and glycated hemoglobin (HbA1c) level. Linear and logistic regression analyses were performed to assess the association between lipid levels and DR.Results: CHOL, TRIG, HDL-C, APOB, APOE, and SDLDL-C levels were significantly higher in the DR group than in the healthy control group, and TRIG levels were lower in the DR group than in the DM group (P < 0.05), especially in the ≤ 57-year-old and the HbA1c ≤ 7.2% subgroups. Linear regression analyses showed that CHOL, TRIG, APOA, APOB, APOE, and SDLDL-C levels were associated with HbA1c levels. Multivariable logistic regression analyses indicated that CHOL (odds ratio [OR] = 1.32, 95% confidence interval [CI] = 1.112– 1.566), TRIG (OR = 1.269, 95% CI = 1.030– 1.563), HDL-C (OR = 43.744, 95% CI = 17.12– 111.769), APOB (OR = 7.037, 95% CI = 3.370– 14.695), APOE (OR = 1.057, 95% CI = 1.038– 1.077), and SDLDL-C (OR = 14.719, 95% CI = 8.304– 26.088) levels were risk factors for DR (P < 0.05).Conclusion: Increased lipid levels were risk factors for DR, and lipid level control should be strengthened, especially in younger adults or in patients with HbA1c ≤ 7.2%.Keywords: lipids, dyslipidemia, diabetes mellitus, diabetic retinopathy, younger population, HbA1c