Is there any Association between Serum Lipids and Diabetic Retinopathy in Type 2 Diabetic Patients in Ghana?
Ilechie A. Alex *
Department of Optometry, University of Cape Coast, Ghana.
M. B. Adinortey
Department of Biochemistry, University of Cape Coast, Ghana.
S. Lartey
Department of Eye, Ear, Nose and Throat, Komfo Anokye Teaching Hospital, Ghana.
I. Amponsah
Department of Mathematics and Statistics, University of Cape Coast, Ghana.
S. B. Boadi-Kusi
Department of Optometry, University of Cape Coast, Ghana.
S. Kyei
Department of Optometry, University of Cape Coast, Ghana.
S. Ocansey
Department of Optometry, University of Cape Coast, Ghana.
E. K. Abu
Department of Optometry, University of Cape Coast, Ghana.
F. Owusu Banahene
Department of Optometry, University of Cape Coast, Ghana.
C. Okoh
Genesis Healthcare, Inc Baltimore MD, USA.
*Author to whom correspondence should be addressed.
Abstract
Aim: To evaluate the association between serum lipids and diabetic retinopathy (DR) in type 2 diabetic subjects.
Study Design: Cross-sectional observational study.
Place and Duration of Study: Diabetes and Ophthalmology units of the
Komfo Anokye Teaching Hospital, Kumasi in the Ashanti Region of
Ghana, between September 2011 and June 2012.
Methodology: Serum levels of total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were assessed in 251 type 2 diabetic mellitus patients. Diagnosis and classification of diabetic retinopathy was based on dilated ophthalmoscopy. Classification of lipid abnormalities was done according to the National Cholesterol Education Programme-Adult Treatment Panel 111 (NCEP-ATP111) Guidelines.
Results: Among 251 type 2 diabetic mellitus patients, 41.0% had retinopathy of which 31% were of the non-proliferative type and 10% were proliferative. The mean ± SD age of the diabetics with retinopathy was 52.64±11.80 years; their mean duration of diabetes was 17.69±4.06 years. Subjects with DR were older (P<0.001), had longer duration of diabetes (P<0.001) and higher fasting blood glucose (P<0.001) than those without DR. HDL-C level (P=0.016) was lower, and TC (P<0.001), TG (P<0.001) and LDL-C levels (P<0.001) were higher in subjects with diabetic retinopathy (DR) compared with those without diabetic retinopathy. Multiple logistic regression analysis revealed that unadjusted TC (odds ratio [OR] 3.57 [95% CI 4.471-12.26] P<0.001), TG (odds ratio [OR] 2.25 [95% CI 1.54-3.2] P<0.0001), HDL-C (odds ratio [OR] 0.664 [95% CI 0 .471- 0.938] P=0.020), and LDL-C (odds ratio [OR] 2.97 [95% CI 2.22-3.96] P<0.001) were associated with DR. After adjusting for age and duration of diabetes, only TC (odds ratio [OR] 4.00 [95% CI 1.12-14.25], P=0.032) maintained a significant association with DR. However, after adjusting for fasting blood glucose (FBG), the association of TC (odds ratio [OR] 30.73 [95% CI 0.018-53.68] P=0.36) with DR lost its significance.
Conclusion: Our analyses suggest that there is no significant association between serum lipids with DR in Ghanaians patients with Type 2 diabetes mellitus. However, further studies are needed to confirm this finding.
Keywords: Serum lipids, diabetic retinopathy, proliferative retinopathy, dyslipidemia, Ghana