Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison.
Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison2American Family Insurance, Madison, Wisconsin.
JAMA Ophthalmol. 2015 May;133(5):503-10. doi: 10.1001/jamaophthalmol.2014.5108.
Total serum and high-density lipoprotein cholesterol have been considered risk factors for severe vascular outcomes in persons with type 1 diabetes mellitus.
To examine the long-term relationships between these 2 serum lipids and the incidence and prevalence of proliferative diabetic retinopathy and macular edema.
DESIGN, SETTING, AND PARTICIPANTS: Nine-hundred three persons with younger-onset type 1 diabetes mellitus who participated in the Wisconsin Epidemiologic Study of Diabetic Retinopathy.
Serum total and high-density cholesterol and history of statin use during the course of 5 visits spanning approximately 30 years (April 10, 1984, to February 13, 2014).
Prevalence and incidence of proliferative diabetic retinopathy and macular edema.
A modest association was found for higher levels of high-density lipoprotein cholesterol and decreased prevalence of proliferative diabetic retinopathy (odds ratio per 10 mg/dL, 0.87; 95% CI, 0.82-0.93), adjusting for duration of diabetes mellitus, glycosylated hemoglobin A1c, statin use, and end-stage renal disease. While adjusting for covariates, no associations of serum total or high-density lipoprotein cholesterol and incident proliferative diabetic retinopathy or macular edema, nor of statin use with decreased incidence of proliferative diabetic retinopathy or macular edema, were identified.
In the course of long-duration diabetes mellitus during a time of changing medical care, there appeared to be little effect of serum lipids or statins on the incidence of proliferative diabetic retinopathy and macular edema.
总血清胆固醇和高密度脂蛋白胆固醇已被认为是 1 型糖尿病患者发生严重血管结局的危险因素。
研究这两种血清脂质与增殖性糖尿病视网膜病变和黄斑水肿的发生率和患病率之间的长期关系。
设计、地点和参与者：903 名年龄较小的 1 型糖尿病患者参加了威斯康星州糖尿病视网膜病变流行病学研究。
血清总胆固醇和高密度胆固醇，以及在大约 30 年的 5 次就诊期间使用他汀类药物的历史（1984 年 4 月 10 日至 2014 年 2 月 13 日）。
增殖性糖尿病视网膜病变和黄斑水肿的患病率和发病率。
发现高水平的高密度脂蛋白胆固醇与增殖性糖尿病视网膜病变的患病率降低之间存在适度的关联（每 10mg/dL 的比值比为 0.87；95%CI，0.82-0.93），调整了糖尿病病程、糖化血红蛋白 A1c、他汀类药物使用和终末期肾病。在调整协变量后，未发现血清总胆固醇或高密度脂蛋白胆固醇与增殖性糖尿病视网膜病变或黄斑水肿的发生率相关，也未发现他汀类药物使用与增殖性糖尿病视网膜病变或黄斑水肿发生率降低相关。
在长期糖尿病病程中，在医疗护理不断变化的时期，血清脂质或他汀类药物对增殖性糖尿病视网膜病变和黄斑水肿的发生率似乎影响不大。
