Abstract
BackgroundTo investigate the effects of dyslipidemia and statin therapy on progression of diabetic retinopathy and diabetic macular edema in patients with type 2 diabetes.MethodsThe medical records of 110 patients with type 2 diabetes (70 statin users and 40 non-users) were retrospectively reviewed. The two outcome measures were progression of diabetic retinopathy by two or more steps on the early treatment diabetic retinopathy study scale and diabetic macular edema based on optical coherence tomography. Serum lipid profiles were analyzed from 6 months prior to diagnosis of diabetic macular edema.ResultsDiabetic retinopathy progressed in 23% of statin users and 18% of non-users (p = 0.506), but diabetic macular edema was present in 23% of statin users and 48% of non-users (p = 0.008). Statins reduced low-density lipoprotein cholesterol levels in patients with and without diabetic macular edema (p = 0.043 and p = 0.031, respectively). Among statin users, patients with diabetic macular edema had higher levels of triglycerides (p = 0.004) and lower levels of high-density lipoprotein cholesterol (p = 0.033) than those without diabetic macular edema. Logistic regression analysis showed that statin use significantly lowered the risk of diabetic macular edema [odds ratio (OR): 0.33, 95% confidence interval (CI) 0.12–0.91, p = 0.032]. Hypertriglyceridemia at 6 months prior to development of macular edema was significantly associated with central retinal thickness (OR: 1.52; 95% CI 1.14–2.02, p = 0.005).ConclusionsLipid lowering therapy with statins protected against the development of diabetic macular edema and progression of diabetic retinopathy in patients with type 2 diabetes. Hypertriglyceridemia could be used as a surrogate marker for diabetic macular edema.
Highlights
To investigate the effects of dyslipidemia and statin therapy on progression of diabetic retinopathy and diabetic macular edema in patients with type 2 diabetes
The fenofibrate intervention and event lowering in diabetes (FIELD) study found that fenofibrate reduced the progression of diabetic retinopathy (DR) in patients with type 2 diabetes [16, 17]
The action to control cardiovascular risk in diabetes (ACCORD) eye study examined the effects of fenofibrate on DR and showed that fenofibrate + simvastatin therapy slowed the progression of DR in patients with type 2 diabetes at 4 years [17, 18], a follow-up study reported that fenofibrate provided no benefit at 8 years [17, 19]
Summary
To investigate the effects of dyslipidemia and statin therapy on progression of diabetic retinopathy and diabetic macular edema in patients with type 2 diabetes. Chung et al Cardiovasc Diabetol (2017) 16:4 diabetic complications in their study of propensity scorematched healthy statin users and non-users These individual studies showed different results, the American College of Cardiology (ACC) and the American Heart Association (AHA) recently recommended statins for all people with diabetes between the ages of 40 and 75 years-old who have low-density lipoprotein (LDL) cholesterol of 70 mg/dL and above. If these guidelines are followed, it would make statins the second-most widely prescribed medication in the world, after hypoglycemic agents for treatment of diabetes [7]. A recent meta-analysis of the relationship of dyslipidemia with diabetic macular edema reported that most studies focused on the prevention of progression of DR, not on diabetic macular edema, because diabetic macular edema is not currently an indication for lipid lowering therapy [20]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
