Abstract
BackgroundDiabetic retinopathy (DR) is the primary oculopathy causing blindness in diabetic patients. Currently, there is increasing interest in the role of lipids in the development of diabetic retinopathy, but it remains controversial. Remnant cholesterol (RC) is an inexpensive and easily measurable lipid parameter; however, the relationship between RC and DR in type 2 diabetes mellitus (T2DM) has not been elucidated. This research investigates the relevance between RC levels and DR severity while building a risk prediction model about DR.MethodsIn this single-centre retrospective cross-sectional study. Each hospitalised T2DM patient had no oral lipid-lowering drugs in the past three months, and coronary angiography showed epicardial coronary artery stenosis of less than 50% and completed seven-field stereo photographs, fluorescein fundus angiography, and optical coherence tomography detection. The RC value is calculated according to the internationally recognised formula. Binary logistic regression was used to correct confounding factors, and the receiver operating characteristic (ROC) analysis was used to identify risk factors and assess the nomogram’s diagnostic efficiency.ResultsA total of 456 T2DM patients were included in the study. The RC levels in the DR team was higher [0.74 (0.60–1.12) mmo/l vs 0.54 (0.31–0.83) mmol/l P < 0.001] in the non-DR team. After adjusting for confounding elements, RC levels are still associated with DR risk (OR = 5.623 95%CI: 2.996–10.556 P < 0.001). The ratio of DR in every stage (except mild non-proliferative diabetic retinopathy) and DME in the high RC level team were further increased compared to the low-level team (all P < 0.001). After ROC analysis, the overall risk of DR was predicted by a nomogram constructed for RC, diabetes duration, and the neutrophil-lymphocyte ratio as 0.758 (95%CI 0.714–0.802 P < 0.001).ConclusionsHigh RC levels may be a potential risk factor for diabetic retinopathy, and the nomogram does better predict DR. Despite these essential findings, the limitation of this study is that it is single-centred and small sample size analysis.
Highlights
As the worldwide prevalence of diabetes mellitus increases, 463 million adults were diagnosed with diabetes in 2019, and according to this trend, there will be 700 million diabetes worldwide by 2045 [1]
Inclusion criteria are: (1) the diagnosis of type 2 diabetes mellitus (T2DM) was per 1999 WHO diagnostic criteria [11]; (2) no gender restrictions on participants over 18 years of age; (3) coronary angiography showed epicardial coronary artery stenosis of less than 50%; (4) completed seven-field stereo photographs, fluorescein fundus angiography (FFA), and Optical Coherence Tomography (OCT) detection, and (5) blood lipid and other biochemical indicators were collected on the second day of admission, and the content was complete
In patients with T2DM, high Remnant cholesterol (RC) levels positively correlate with the occurrence and severity of Diabetic retinopathy (DR)
Summary
As the worldwide prevalence of diabetes mellitus increases, 463 million adults were diagnosed with diabetes in 2019, and according to this trend, there will be 700 million diabetes worldwide by 2045 [1]. Diabetic retinopathy (DR) is a prevalent neurovascular complication of diabetes mellitus and is the leading cause of blindness in the working-age generation [2]. Diabetes duration, microalbuminuria, and blood pressure levels are known risk elements for the development and advance of DR, current studies report that there may be other, as yet unknown, risk factors for the disease [3]. The association of dyslipidemia with DR has been thoroughly investigated. In many extensive studies, controversy still exists regarding the exact role of dyslipidemia in DR [4, 5]. Diabetic retinopathy (DR) is the primary oculopathy causing blindness in diabetic patients. There is increasing interest in the role of lipids in the development of diabetic retinopathy, but it remains controversial.
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