2型糖尿病患者血脂异常与糖尿病视网膜病变的关联：一项基于医院的研究
Association of Dyslipidemia with Diabetic Retinopathy in Type 2 Diabetes Mellitus Patients: A Hospital-Based Study.
作者信息
Ezhilvendhan Kalaimamani, Sathiyamoorthy Anitha, Prakash B Jey, Bhava B Saravana, Shenoy Arjun
机构信息
Professor and HOD, Department of ophthalmology,Vinayaka mission's kirupananda variyar medical college, salem, India.
Final year postgraduate, Department of ophthalmology, Vinayaka mission's medical college and hospital, Salem, India.
出版信息
J Pharm Bioallied Sci. 2021 Nov;13(Suppl 2):S1062-S1067. doi: 10.4103/jpbs.jpbs_164_21. Epub 2021 Nov 10.
BACKGROUND
Dyslipidemia is an important risk factor that can lead to the progression of retinopathy (DR). Diabetic dyslipidemia with low high-density lipoprotein (HDL) and increased triglycerides (TGs) are seen frequently among Type 2 diabetic mellitus.
AIMS AND OBJECTIVES
(1) To assess the level of serum lipids (total cholesterol, TGs, HDL, and low-density lipoprotein [LDL]) among type 2 diabetes patients. (2) To determine the association between serum lipid levels and DR.
MATERIALS AND METHODS
This was a hospital-based cross-sectional study conducted in a tertiary care hospital in Salem from September 2018 to March 2020 with a sample size of 200. Details of their diabetic history were obtained. Patients were evaluated for their HbA1C levels, hypertension, and lipid profile status. Early treatment DR Study system was used to classify DR. Low density lipoprotein cholesterol was calculated by Freidewald's equation.
RESULTS
This study showed a significant association among DR and LDL cholesterol. DR with raised LDL, TGs levels, and lowered HDL on adjusted analysis. There was strong association between DR and serum cholesterol in unadjusted analysis; however, there was no association when adjusted for factors such as age, gender, duration of diabetes, and glycemic control. Majority of participants were males (57.5%) with a male: female = 1.35:1. The mean age of the patients in our study was 57.8 (5.8) years and 54.4 (6.6) years in patients with DR and patients without retinopathy, and it was found to be statistically significant. There was a significant difference in the duration of diabetes with the presence of DR and the patients with DR were having longer duration of diabetes (7.9 vs. 6.2 years; < 0.001). Moderate nonproliferative diabetic retinopathy (NPDR) was found to be present in 41.0% of eyes followed by mild NPDR (20.5% eyes). Proliferative diabetic retinopathy was present only in 9.5%, and the severity of retinopathy was associated only with the HDL level, and there was no association found with total cholesterol, TG, and LDL cholesterol.
CONCLUSION
A statistically significant correlation was found between dyslipidemia and the severity of DR among Type 2 diabetic patients.
背景
血脂异常是导致视网膜病变（DR）进展的重要危险因素。2型糖尿病患者中经常出现高密度脂蛋白（HDL）低和甘油三酯（TG）升高的糖尿病血脂异常情况。
目的
（1）评估2型糖尿病患者的血脂水平（总胆固醇、TG、HDL和低密度脂蛋白[LDL]）。（2）确定血脂水平与DR之间的关联。
材料与方法
这是一项于2018年9月至2020年3月在塞勒姆一家三级护理医院进行的基于医院的横断面研究，样本量为200。获取了他们的糖尿病病史细节。对患者进行了糖化血红蛋白水平、高血压和血脂谱状况评估。使用早期治疗DR研究系统对DR进行分类。低密度脂蛋白胆固醇通过弗赖德瓦尔德方程计算。
结果
本研究显示DR与LDL胆固醇之间存在显著关联。经调整分析，DR患者的LDL、TG水平升高，HDL降低。在未调整分析中，DR与血清胆固醇之间存在强关联；然而，在调整年龄、性别、糖尿病病程和血糖控制等因素后，不存在关联。大多数参与者为男性（57.5%），男女比例为1.35:1。我们研究中患者的平均年龄为57.8（5.8）岁，DR患者和无视网膜病变患者的平均年龄分别为54.4（6.6）岁，差异具有统计学意义。DR患者与无DR患者的糖尿病病程存在显著差异，DR患者的糖尿病病程更长（7.9对6.2年；<0.001）。41.0%的眼睛存在中度非增殖性糖尿病视网膜病变（NPDR），其次是轻度NPDR（20.5%的眼睛）。增殖性糖尿病视网膜病变仅占9.5%，视网膜病变的严重程度仅与HDL水平相关，与总胆固醇、TG和LDL胆固醇无关。
结论
发现2型糖尿病患者血脂异常与DR严重程度之间存在统计学显著相关性。
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