Key result
Elevated lipid indices, including the atherogenic index of plasma, were significantly higher in type 2 diabetes patients with diabetic retinopathy compared to healthy controls (0.72 vs 0.52, p=0.001).
Why the study?
Lipid indices may be associated with bio-physiological changes of diabetic retinopathy even when traditional lipids are normal, warranting evaluation of their predictive role in assessing microvascular risk.
Do lipid indices correlate with the presence of diabetic retinopathy in patients with type 2 diabetes mellitus?
Case-Control (n=90)
No
Do lipid indices correlate with the presence of diabetic retinopathy in patients with type 2 diabetes mellitus?
Absolute Event Rate: 0.72% vs 0.52%
p-value: p=0.001
Lipid indices such as AIP, AC, and non-HDL-C are significantly elevated in T2DM patients with diabetic retinopathy and may serve as useful markers for assessing microvascular risk even when traditional lipid profiles appear normal.
Lipid indices may aid DR risk assessment in diabetes with normal lipids; leaves open need for prospective validation before practice change.
INTRODUCTION: Diabetic retinopathy (DR) remains the leading cause of blindness and visual impairment in diabetic patients worldwide. Lipid indices (LI) such as atherogenic coefficient (AC), atherogenic index of plasma (AIP), non-high-density lipoprotein cholesterol (non-HDL-C), and Castelli risk index (CRI) I and II may be associated with bio-physiological changes of DR even when traditional lipids are within normal limit. Hence, the present study was undertaken to evaluate the LI and examine the LI predictive role in assessing the microvascular risk in diabetes patients with and without retinopathy. METHODOLOGY: This case-control study was conducted for six months at a tertiary care hospital and included 90 subjects divided into three groups. Group I had 30 age and sex-matched healthy controls; group II and group III had 30 type 2 diabetes mellitus (T2DM) cases without DR and with DR, respectively. Plasma glucose and lipid profiles including apolipoprotein A-I (Apo A-I) and apolipoprotein B (Apo B) were measured in all subjects. LI such as AIP, AC, CRI-I, CRI-II, and non-HDL-C were calculated from the lipid profile values. ANOVA test was used to compare the means of three groups. RESULTS: The mean age of the study participants was 51.44 ± 11.72, 53.95 ± 12.43, and 57.16 ± 7.96 years for groups I, II, and III, respectively. Triacylglycerol (TG) showed positive correlation with all LI, AIP (r = 0.768, p < 0.00001), AC (r = 0.363, p = 0.048), non-HDL-C (r = 0.372, p = 0.042), and CRI-I (r = 0.363, p = 0.048), except for CRI-II in group III. Low-density lipoprotein cholesterol (LDL-C) showed a statistically significant positive correlation with non-HDL-C and CRI-II in diabetic subjects with and without retinopathy. CONCLUSION: The study showed that LI were raised in diabetic patients with or without DR, suggesting the significant role of LI in assessing microvascular risk in T2DM, particularly when the lipid profile values seem to be normal or not disturbed markedly.
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Namitha et al. (2022) conducted a case-control in Type 2 Diabetes Mellitus and Diabetic Retinopathy (n=90). Elevated lipid indices vs. Healthy controls was evaluated on Atherogenic index of plasma (AIP) (p=0.001). Elevated lipid indices, including the atherogenic index of plasma, were significantly higher in type 2 diabetes patients with diabetic retinopathy compared to healthy controls (0.72 vs 0.52, p=0.001).
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