Romero-Aroca Pedro, Verges Raquel, Pascual-Fontanilles Jordi, Valls Aida, Franch Josep, Barrot Joan, Mundet Xavier, La Torre Alex, Moreno Antonio, Sagarra Ramon, Basora Josep, Garcia-Curto Eugeni, Baget-Bernaldiz Marc
Ophthalmology Service, University Hospital Sant Joan, Institut de Investigacio Sanitaria Pere Virgili (IISPV), 43204 Reus, Spain.
ITAKA Research Group, Department of Computer Science and Mathematics, Universitat Rovira i Virgili, 43007 Tarragona, Spain.
J Clin Med. 2023 Oct 22;12(20):6674. doi: 10.3390/jcm12206674.
(1) Background: Diabetic retinopathy (DR) remains the leading cause of low vision and blindness in young adults of working age. Although the most important risk factors-such as the duration of diabetes mellitus (DM) and glycemic control measured by HbA1c-are known, the effects of lipids are not as clear. The aim of the present study is to analyze the effects of lipids on the development of DR. (2) Methods: This is a retrospective study of a population of 175,645 DM2 patients, during the period 2010 to 2020, in which the effects of different lipid factors are studied. (3) Results: The variables that most influenced the development of DR in our study, based on significance and cumulative hazard (CH), were arterial hypertension (CH 1.217, < 0.001), HbA1c levels (CH 1.162, = 0.001), microalbuminuria (CH 1.012, < 0.001), LDL-C cholesterol (CH 1.007, = 0.012), TC/HDL-C index (CH 1.092, < 0.001), No-HDL-C/HDL-C index (CH 1.065, = 0.002), the use of statins (CH 1.001, = 0.005), and body mass index (CH 1.007, < 0.001). (4) Conclusions: LDL-cholesterol, TC/HDL-C, and No-HDL-C/HDL-C indices are related to the development of DR, and there is a protective effect of HDL-cholesterol and the use of fibrates.
（1）背景：糖尿病视网膜病变（DR）仍是工作年龄的年轻成年人视力低下和失明的主要原因。尽管已知最重要的风险因素，如糖尿病（DM）病程和通过糖化血红蛋白（HbA1c）衡量的血糖控制情况，但血脂的影响尚不清楚。本研究的目的是分析血脂对DR发生发展的影响。（2）方法：这是一项对175645例2型糖尿病患者在2010年至2020年期间进行的回顾性研究，研究了不同血脂因素的影响。（3）结果：在我们的研究中，基于显著性和累积风险（CH），对DR发生发展影响最大的变量是动脉高血压（CH 1.217，P<0.001）、HbA1c水平（CH 1.162，P = 0.001）、微量白蛋白尿（CH 1.012，P<0.001）、低密度脂蛋白胆固醇（LDL-C）（CH 1.007，P = 0.012）、总胆固醇/高密度脂蛋白胆固醇（TC/HDL-C）指数（CH 1.092，P<0.001）、非高密度脂蛋白胆固醇/高密度脂蛋白胆固醇（No-HDL-C/HDL-C）指数（CH 1.065，P = 0.002）、他汀类药物的使用（CH 1.001，P = 0.005）和体重指数（CH 1.007，P<0.001）。（4）结论：低密度脂蛋白胆固醇、TC/HDL-C和No-HDL-C/HDL-C指数与DR的发生发展有关，高密度脂蛋白胆固醇和贝特类药物的使用具有保护作用。
