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Year : 2018  |  Volume : 5  |  Issue : 1  |  Page : 19-31

The effect of serum lipid control on diabetic retinopathy stages in Saudi adults

1 Ophthalmologist MD, Department of Retina, Makkah Eye Complex, Khartoum, Sudan
2 Ophthalmologist MD, Department of Retina, Makkah Eye Complex; Professor of Ophthalmology, Faculty of Medicine, Al Neelain University, Department of Ophthalmology and Department of Retina, Makkah Eye Complex, Khartoum, Sudan

Correspondence Address:
Dr. Abbashar M Saleem
Department of Retina, Makkah Eye Complex, P.O. Box. 10139, Khartoum 11111
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/bijo.bijo_11_18

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Objectives: The objective was to study the effect of serum lipid control on diabetic retinopathy (DR) stages. Materials and Methods: Two hundred type 2 diabetic Saudi patients with or without using lipid-lowering-agents were included in this cross-sectional study (4 months: July–October 2015). All patients had standardized ophthalmological examination and fasting biochemical parameters of glycosylated hemoglobin (HbA1c) and serum lipid levels, and were then subjected to “statistical analysis by SPSS software version 20. Results: Out of the 200 studied patients (mean age, 62.9 ± 9.43 years), 104 were male (n = 104; 52%) and 96 were female (n = 96; 48%). The mean duration of diabetes mellitus (DM) and concomitant hypertension (n = 107; 53.5%) was 16.3 and 10.3 years, respectively. A total of 106 (53%) patients had diabetic retinopathy (DR), with 66 males (33%) and 40 females (20%). Ninety-four patients had no signs of DR (no apparent DR [NDR]) (47%), with 19% of males and 28% of females. Mild nonproliferative DR (NPDR) was present in 15.5% of patients (male/female: 10%/5.5%); moderate NPDR was present in 22.5% of patients (male/female: 13.5%/9%); and severe NPDR was present in 8% of patients (male/female: 5%/3%). Proliferative DR (PDR) was present in 5% of patients (male/female: 13.5%/3%), advanced PDR was present in 2% of patients (male/female: 1%/1%), and diabetic macular edema (DME) was present in 9.5% of patients (male/female: 7%/2.5%). Total cholesterol (TC) (P = 1.292), low-density lipoprotein-cholesterol (LDL-C) (P = 1.319), and nonhigh-density lipoprotein-cholesterol (HDL-C) (P = 0.96) were found to have a statistically “nonsignificant” higher value in male DR patients. No correlation was observed between triglyceride (TG), HDL-C, and very LDL-C (VLDL-C) in different stages of DR and NDR patients, as they were exactly equal in both DR and NDR male groups. All DM females (DR + NDR) had equal values regarding TC, HDL-C, LDL-C, and VLDL-C in both female groups. TG and non-HDL-C were slightly higher in female DR groups than that in non-DR female groups (P = 0.071 and 0.072, respectively). However, TC and non-HDL-C were still higher in females than males by 4.3%. 116 (58%) “who were not using dyslipidemia medications” (NDLRx) and 84 (42%) “who were using dyslipidemia medications” (DLRx); their DM and HTN duration were 15.9 and 5 years, respectively. HbA1c and serum lipid parameters were also higher in in the NDLRx group than DLRx group. Conclusion: Dyslipidemia could be added to DR risk factors as the development of elevated serum lipids shows some association with DR ± DME formation. Serum lipid-lowering agents may help in reducing the occurrence of retinal findings and loss of vision in diabetic patients.

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