Relationship between serum apolipoproteins levels and retinopathy risk in subjects with type 2 diabetes mellitus.

AIMS

Prognostic significance of apolipoproteins in diabetic retinopathy risk has not been well investigated. The aim of this study was to reveal the relationship between the risk of diabetic retinopathy and the levels of several apolipoproteins and their ratios in a 10-year prospective cohort.

METHODS

A total of 1023 diabetic patients without retinopathy were selected from a 10-year hospital-based diabetic cohort. In this cohort, all subjects had type 2 diabetes. Blood samples were obtained, and serum levels of several apolipoproteins were measured. In the follow-up period, diabetic retinopathy was diagnosed by two ophthalmologists through a series of ophthalmologic examinations. A Cox proportional hazard analysis was adopted to determine the relationship between the risk of diabetic retinopathy and the levels of several apolipoproteins and their ratios.

RESULTS

In the follow-up period, 315 diabetic patients were suffered from diabetic retinopathy, and the remaining 708 patients did not. Baseline serum level of apoAI ≥ 7.4 μmol/L was related to the decreased risk of diabetic retinopathy (HR 0.86, 95% CI 0.70-0.99). Baseline levels of apoCIII ≥ 6.3 μmol/L, apoE ≥ 1.1 μmol/L, apoCIII-to-apoAI ratio ≥ 0.9 and apoE-to-apoAI ratio ≥ 0.2 were associated with the increased risk of this complication (HR 1.25, 95% CI 1.04-1.49; HR 1.23, 95% CI 1.03-1.47; HR 1.34, 95% CI 1.11-1.60; HR 1.21, 95% CI 1.01-1.46).

CONCLUSION

Elevated level of apoAI might be a protective factor for diabetic retinopathy. Increased levels of apoCIII, apoE, apoCIII-to-apoAI and apoE-to-apoAI ratios might be risk factors for this complication.