Relevance of the serum apolipoprotein ratio to diabetic retinopathy.

PURPOSE: To determine the correlations among apoA-1, apoB, and apoB/A-1, the ratio of the first two and their relation to the severity of diabetic retinopathy (DR).
METHODS: A total of 116 patients with type 2 diabetes, 34 with nonproliferative diabetic retinopathy (NPDR) and 82 with proliferative diabetic retinopathy (PDR), were included. The serum levels of apoA-1, apoB, and the apoB/A-1 ratio were compared. We performed multiple regression analyses to determine whether age, diabetes duration, glycohemoglobin level, estimated glomerular filtration rate, body mass index, or hypertension contribute to PDR.
RESULTS: The apoB levels were lower in the NPDR group than in the PDR group (90.8 ± 21.4 versus 102.5 ± 25.3 mg/dl) (P = 0.02). The apoA-1 levels did not differ between the groups. The apoA-1 was lower in the PDR group than in the NPDR group (136.9 ± 24.9 versus 145.6 ± 21.2 mg/dl) mg/dl (P = 0.08). The apoB/A-1 ratio differed significantly between groups (NPDR versus PDR, 0.64 ± 0.20 versus 0.77 ± 0.24) (P = 0.004). Age, apoB/A-1, and diabetes duration were independent risk factors for PDR (R = -3.49, 3.06, and 2.44; standard regression coefficient, -0.33, 0.28, and 0.23; P = 0.0007, P = 0.003, and P = 0.02, respectively). The PDR group had significantly higher serum levels of apoB and apoB/A-1 than the NPDR group.
CONCLUSIONS: The apoB/A-1 ratio may contribute to PDR progression in patients with DR. High apoB and apoB/A-1 values may be related to PDR development.