Dyslipidemia and Diabetic Retinopathy

Overview

Journal Rev Diabet Stud

Specialty Endocrinology

Date 2014 Jan 1

PMID 24380088

Citations 53

Authors

Yo-Chen Chang

Wen-Chuan Wu

Affiliations

Soon will be listed here.

Abstract

Diabetic retinopathy (DR) is one of the major microvascular complications of diabetes. In developed countries, it is the most common cause of preventable blindness in diabetic adults. Dyslipidemia, a major systemic disorder, is one of the most important risk factors for cardiovascular disease. Patients with diabetes have an increased risk of suffering from dyslipidemia concurrently. The aim of this article is to review the association between diabetic retinopathy (DR) and traditional/nontraditional lipid markers, possible mechanisms involving lipid metabolism and diabetic retinopathy, and the effect of lipid-lowering therapies on diabetic retinopathy. For traditional lipid markers, evidence is available that total cholesterol and low-density lipoprotein cholesterol are associated with the presence of hard exudates in patients with DR. The study of nontraditional lipid markers is advancing only in recently years. The severity of DR is inversely associated with apolipoprotein A1 (ApoA1), whereas ApoB and the ApoB-to-ApoA1 ratio are positively associated with DR. The role of lipid-lowering medication is to work as adjunctive therapy for better control of diabetes-related complications including DR.

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References

Koya D, King G . Protein kinase C activation and the development of diabetic complications. Diabetes. 1998; 47(6):859-66. DOI: 10.2337/diabetes.47.6.859. View

Cullen J, Town S, Campbell C . Double-blind trial of Atromid-S in exudative diabetic retinopathy. Trans Ophthalmol Soc U K (1962). 1974; 94(2):554-62. View

van Leiden H, Dekker J, Moll A, Nijpels G, Heine R, Bouter L . Blood pressure, lipids, and obesity are associated with retinopathy: the hoorn study. Diabetes Care. 2002; 25(8):1320-5. DOI: 10.2337/diacare.25.8.1320. View

Harrold B, Marmion V, GOUGH K . A double-blind controlled trial of clofibrate in the treatment of diabetic retinopathy. Diabetes. 1969; 18(5):285-91. DOI: 10.2337/diab.18.5.285. View

Davidson M . Apolipoprotein measurements: is more widespread use clinically indicated?. Clin Cardiol. 2009; 32(9):482-6. PMC: 6653425. DOI: 10.1002/clc.20559. View

Miljanovic B, Glynn R, Nathan D, Manson J, Schaumberg D . A prospective study of serum lipids and risk of diabetic macular edema in type 1 diabetes. Diabetes. 2004; 53(11):2883-92. DOI: 10.2337/diabetes.53.11.2883. View

Hammes H, Martin S, Federlin K, Geisen K, Brownlee M . Aminoguanidine treatment inhibits the development of experimental diabetic retinopathy. Proc Natl Acad Sci U S A. 1991; 88(24):11555-8. PMC: 53174. DOI: 10.1073/pnas.88.24.11555. View

Colhoun H, Betteridge D, Durrington P, Hitman G, Neil H, Livingstone S . Primary prevention of cardiovascular disease with atorvastatin in type 2 diabetes in the Collaborative Atorvastatin Diabetes Study (CARDS): multicentre randomised placebo-controlled trial. Lancet. 2004; 364(9435):685-96. DOI: 10.1016/S0140-6736(04)16895-5. View

. The Lipid Research Clinics Coronary Primary Prevention Trial results. I. Reduction in incidence of coronary heart disease. JAMA. 1984; 251(3):351-64. DOI: 10.1001/jama.1984.03340270029025. View

10.

Mohamed Q, Gillies M, Wong T . Management of diabetic retinopathy: a systematic review. JAMA. 2007; 298(8):902-16. DOI: 10.1001/jama.298.8.902. View

11.

Nathan D, Genuth S, Lachin J, Cleary P, Crofford O, Davis M . The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993; 329(14):977-86. DOI: 10.1056/NEJM199309303291401. View

12.

Morton J, Zoungas S, Li Q, Patel A, Chalmers J, Woodward M . Low HDL cholesterol and the risk of diabetic nephropathy and retinopathy: results of the ADVANCE study. Diabetes Care. 2012; 35(11):2201-6. PMC: 3476889. DOI: 10.2337/dc12-0306. View

13.

. Blood pressure, cholesterol, and stroke in eastern Asia. Eastern Stroke and Coronary Heart Disease Collaborative Research Group. Lancet. 1998; 352(9143):1801-7. View

14.

Hill S, McQueen M . Reverse cholesterol transport--a review of the process and its clinical implications. Clin Biochem. 1997; 30(7):517-25. DOI: 10.1016/s0009-9120(97)00098-2. View

15.

Schultz J, Verstuyft J, Gong E, NICHOLS A, Rubin E . Protein composition determines the anti-atherogenic properties of HDL in transgenic mice. Nature. 1993; 365(6448):762-4. DOI: 10.1038/365762a0. View

16.

Santos A, Salguero M, Gurrola C, Munoz F, Roig-Melo E, Panduro A . The epsilon4 allele of apolipoprotein E gene is a potential risk factor for the severity of macular edema in type 2 diabetic Mexican patients. Ophthalmic Genet. 2002; 23(1):13-9. DOI: 10.1076/opge.23.1.13.2203. View

17.

Rema M, Srivastava B, Anitha B, Deepa R, Mohan V . Association of serum lipids with diabetic retinopathy in urban South Indians--the Chennai Urban Rural Epidemiology Study (CURES) Eye Study--2. Diabet Med. 2006; 23(9):1029-36. DOI: 10.1111/j.1464-5491.2006.01890.x. View

18.

Maioli M, Tonolo G, Pacifico A, Ciccarese M, Brizzi P, Kohner E . Raised serum apolipoprotein (a) in active diabetic retinopathy. Diabetologia. 1993; 36(1):88-90. DOI: 10.1007/BF00399100. View

19.

Grundy S, Cleeman J, Merz C, Brewer Jr H, Clark L, Hunninghake D . Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. Circulation. 2004; 110(2):227-39. DOI: 10.1161/01.CIR.0000133317.49796.0E. View

20.

McQueen M, Hawken S, Wang X, Ounpuu S, Sniderman A, Probstfield J . Lipids, lipoproteins, and apolipoproteins as risk markers of myocardial infarction in 52 countries (the INTERHEART study): a case-control study. Lancet. 2008; 372(9634):224-33. DOI: 10.1016/S0140-6736(08)61076-4. View