Abstract:
Aim: To evaluate the association between serum lipids and diabetic retinopathy (DR) in
type 2 diabetic subjects.
Study Design: Cross-sectional observational study.
Place and Duration of Study: Diabetes and Ophthalmology units of the
Komfo Anokye Teaching Hospital, Kumasi in the Ashanti Region of
Ghana, between September 2011 and June 2012.
Methodology: Serum levels of total cholesterol (TC), triglyceride (TG), high-density
lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were
assessed in 251 type 2 diabetic mellitus patients. Diagnosis and classification of diabetic
retinopathy was based on dilated ophthalmoscopy. Classification of lipid abnormalities
was done according to the National Cholesterol Education Programme-Adult Treatment
Panel 111 (NCEP-ATP111) Guidelines.
Results: Among 251 type 2 diabetic mellitus patients, 41.0% had retinopathy of which
31% were of the non-proliferative type and 10% were proliferative. The mean ± SD age
of the diabetics with retinopathy was 52.64±11.80 years; their mean duration of diabetes
was 17.69±4.06 years. Subjects with DR were older (P<0.001), had longer duration of
diabetes (P<0.001) and higher fasting blood glucose (P<0.001) than those without DR.
HDL-C level (P=0.016) was lower, and TC (P<0.001), TG (P<0.001) and LDL-C levels
(P<0.001) were higher in subjects with diabetic retinopathy (DR) compared with those
without diabetic retinopathy. Multiple logistic regression analysis revealed that unadjusted
TC (odds ratio [OR] 3.57 [95% CI 4.471-12.26] P<0.001), TG (odds ratio [OR] 2.25 [95%
CI 1.54-3.2] P<0.0001), HDL-C (odds ratio [OR] 0.664 [95% CI 0 .471- 0.938] P=0.020),
and LDL-C (odds ratio [OR] 2.97 [95% CI 2.22-3.96] P<0.001) were associated with DR.
After adjusting for age and duration of diabetes, only TC (odds ratio [OR] 4.00 [95% CI
1.12-14.25], P=0.032) maintained a significant association with DR. However, after
adjusting for fasting blood glucose (FBG), the association of TC (odds ratio [OR] 30.73
[95% CI 0.018-53.68] P=0.36) with DR lost its significance.
Conclusion: Our analyses suggest that there is no significant association between serum
lipids with DR in Ghanaians patients with Type 2 diabetes mellitus. However, further
studies are needed to confirm this finding.
