Evangelia Papavasileiou1, Samaneh Davoudi1, Ramak Roohipoor1,2, Heeyoon Cho1,3, Shreyas Kudrimoti1, Heather Hancock4, James G Wilson5, Christopher Andreoli6, Deeba Husain1, Maurice James7, Alan Penman5,8, Ching J Chen4, Lucia Sobrin9. 1. Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA, 02114, USA. 2. Department of Ophthalmology, Farabi Eye Hospital, Eye Research Center, Tehran University of Medical Sciences, Tehran, Iran. 3. Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Korea. 4. Department of Ophthalmology, University of Mississippi Medical Center, Jackson, MS, USA. 5. Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS, USA. 6. Visual Services Department, Harvard Vanguard Medical Associates, Boston, MA, USA. 7. Ophthalmology, St Dominic's Hospital, Jackson, MS, USA. 8. Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson, MS, USA. 9. Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA, 02114, USA. Lucia_sobrin@meei.harvard.edu.
Abstract
PURPOSE: Previous studies have yielded conflicting results regarding whether serum lipid levels are associated with retinal hard exudates in diabetic retinopathy. The majority of studies have assessed hard exudates only as a dichotomous trait (presence vs. absence) and included limited numbers of African Americans (AA). The purpose of this study was to determine if there are any associations between serum lipid levels and hard exudates in AA with type 2 diabetes (T2D). METHODS: 890 AA participants with T2D were enrolled from 5 sites. Macular fundus photographs were graded by masked ophthalmologist investigators. Hard exudate areas were measured using a semi-automated algorithm and ImageJ software. Multivariate regression models were used to determine the association between serum lipid levels and (1) presence of hard exudate and (2) area of hard exudate. RESULTS: Presence of hard exudates was associated with higher total cholesterol [(odds ratio (OR) = 1.08, 95 % confidence interval (CI) 1.03-1.13, P = 0.001)] and higher low-density lipoprotein (LDL) cholesterol (OR = 1.08, 95 % CI 1.03-1.14, P = 0.005) in models controlling for other risk factors. Hard exudate area was also associated with both higher total and LDL cholesterol levels (P = 0.04 and 0.01, respectively) in multivariate models controlling for other risk factors. CONCLUSIONS: Higher total and LDL cholesterol were associated with the presence of hard exudates and a greater hard exudate area in AA with T2D. This information can be used to counsel diabetic patients regarding the importance of lipid control to decrease the risk of macular hard exudates.
PURPOSE: Previous studies have yielded conflicting results regarding whether serum lipid levels are associated with retinal hard exudates in diabetic retinopathy. The majority of studies have assessed hard exudates only as a dichotomous trait (presence vs. absence) and included limited numbers of African Americans (AA). The purpose of this study was to determine if there are any associations between serum lipid levels and hard exudates in AA with type 2 diabetes (T2D). METHODS: 890 AA participants with T2D were enrolled from 5 sites. Macular fundus photographs were graded by masked ophthalmologist investigators. Hard exudate areas were measured using a semi-automated algorithm and ImageJ software. Multivariate regression models were used to determine the association between serum lipid levels and (1) presence of hard exudate and (2) area of hard exudate. RESULTS: Presence of hard exudates was associated with higher total cholesterol [(odds ratio (OR) = 1.08, 95 % confidence interval (CI) 1.03-1.13, P = 0.001)] and higher low-density lipoprotein (LDL) cholesterol (OR = 1.08, 95 % CI 1.03-1.14, P = 0.005) in models controlling for other risk factors. Hard exudate area was also associated with both higher total and LDL cholesterol levels (P = 0.04 and 0.01, respectively) in multivariate models controlling for other risk factors. CONCLUSIONS: Higher total and LDL cholesterol were associated with the presence of hard exudates and a greater hard exudate area in AA with T2D. This information can be used to counsel diabeticpatients regarding the importance of lipid control to decrease the risk of macular hard exudates.
Entities:
Keywords:
African Americans; Hard exudate area; Serum lipid levels; Type 2 diabetes
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