Is there any Association between Serum Lipids and Diabetic Retinopathy in Type 2 Diabetic Patients in Ghana?

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.