Association of serum lipid levels with diabetic retinopathy in a tertiary care centre in Tamilnadu

AIM OF THE STUDY: Primary Aim: To study association between serum lipid levels & severity of Diabetic retinopathy Secondary Aim: To assess the proportion of patients with dyslipidemia among patients with diabetic retinopathy To assess association between various types of lipoproteins with diabetic retinopathy MATERIALS AND METHODS: This is a prospective observational study conducted among patients attending Ophthalmology OPD in a tertiary care hospital.It is a cross-sectional,hospital based study spanning over a period of 18 months from June 2011 to November 2012.100 type 2 diabetic patients attending Ophthalmology OPD were examined by ophthalmoscopy and fundus fluorescein angiography.Their diabetic retinopathy status was graded according to ETDRS classification.Their serum lipid levels were assessed.Association between serum lipid levels and retinopathy severity were assessed using SPSS software. RESULTS: In our study the incidence of diabetic retinopathy was 55% and 45% had no features of diabetic retinopathy. In our study, 45% had no signs of diabetic retinopathy, 46% had non-proliferative retinopathy and 9% had proliferative retinopathy. Mean age in the no diabetic retinopathy group was 54.02,in NPDR group it was 57.56 and in the PDR group it was 55.55. According to our study,the mean total cholesterol levels are 177.22 in diabetics without retinopathy, 186.86 in NPDR and 159.33 in PDR. 20 of the 55 patients (36.3%) with retinopathy had elevated serum total cholesterol levels.63.6% of retinopathy patients had desirable cholesterol levels.The mean triglyceride levels were calculated as 141.97 in diabetics without diabetic retinopathy, 163.13 in NPDR and 195.00 in PDR patients. The mean HDL values were 39.73 in diabetics without diabetic retinopathy, 36.80 in NPDR and 31.66 in PDR. Mean LDL levels in diabetics without diabetic retinopathy was 113.13, 116.04 in NPDR and 99.33 in PDR. 22 of 55 retinopathy cases (40%) had optimal levels of LDL.Mean glycosylated haemoglobin level was 8.12 in diabetics without retinopathy, 8.74 in NPDR AND 10.00 in PDR . Mean Fasting blood glucose level was 154.22 in diabetics without retinopathy, 169.63 in NPDR and 191.11 in PDR. Mean creatinine level was 0.75 in diabetics without retinopathy, 0.80 in NPDR and 0.86 in PDR. Mean serum haemoglobin is 13.33 in diabetics without retinopathy, 13.17 in NPDR and 11.87 in PDR. CONCLUSION: No significance was found with severity of diabetic retinopathy and total serum cholesterol, serum triglyceride,HDL and LDL levels.Of the retinopathy patients, 36.3% had elevated serum total cholesterol levels, 70.9% had low HDL and 60% elevated LDL levels.No significant association was found between severity of diabetic retinopathy and fasting blood glucose levels and also serum creatinine levels.There was significant association between glycosylated hemoglobin and diabetic retinopathy severity.And also significant negative association with haemoglobin levels and severity of diabetic retinopathy.