Role of Low Density Lipoprotein Cholesterol in Progression of Diabetic Retinopathy CC01-CC04
Dr. Mayank Agarwal,
Hind Institute of Medical Sciences, Safedabad, Barabanki, Uttar Pradesh, India.
Introduction: Various cross-sectional studies indicate that dyslipidemia and increased activity of enzyme Aldose Reductase (ALDR-2) are associated with the establishment of Diabetic Retinopathy (DR). However, it remains unclear that among dyslipidemia and ALDR-2 activity, which is more important for the progression of DR from nonproliferative to the proliferative stage.
Aim: The present study was designed to explore the role of dyslipidemia and ALDR-2 activity in the progression of DR.
Materials and Methods: Two hundred subjects were involved in this cross-sectional study, 150 subjects had Type 2 diabetes while 50 had No Diabetes and No Retinopathy (NDNR) and acted as a control. On the basis of fundus examination, diabetic subjects were further divided equally into those having: No Retinopathy (DNR), Non-Proliferative DR (NPDR), and Proliferative DR (PDR). Fasting lipid profile, ALDR-2 level, fasting and post prandial blood sugar were measured using a standard protocol. Data were analysed using both descriptive and inferential statistics using unpaired t-test.
Results: ALDR-2 level was significantly (p-value=0.0001) higher in NPDR than DNR. Low-Density Lipoprotein Cholesterol (LDL-C) was significantly (p-value=0.0235) higher in PDR than NPDR. Fasting Blood Sugar (FBS), Post Prandial Blood Sugar (PPS), and LDL-C were significantly higher in DNR than NDNR while high-density lipoprotein cholesterol was significantly lower in DNR than NDNR group.
Conclusion: Persistent hyperglycaemia causes an increased ALDR-2 activity that has a significant role in the establishment of DR. However, dyslipidemia is more important as a risk factor for progression of NPDR to PDR. Hypolipidemic drug as an adjunctive therapy could prevent the progression of DR from NPDR to PDR.