Association of Lipid Profile with the Severity of Diabetic Retinopathy: A Cross-sectional Study

Introduction: Diabetic Retinopathy (DR) is a microvascular complication of diabetes that damages the retina and is the primary cause of irreversible vision loss among young adults of working age worldwide. It is important to understand the risk factors, such as dyslipidemia, as they have been linked to the pathogenesis and progression of this microvascular disease. Aim: To assess the association of lipid profiles with the severity of DR. Materials and Methods: This cross-sectional study included 150 participants of both genders with type 2 diabetes, aged 35-80 years, attending the Retina Clinic at the Outpatient Department (OPD) of Ophthalmology, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India, between December 2021 and December 2022. The Early Treatment Diabetic Retinopathy Scale (ETDRS) was used to grade the severity of DR. Results: The mean age of diabetic patients with Non Proliferative Diabetic Retinopathy (NPDR) was 53.28±8.56 years, while the mean age of those without DR was 54.35±7.79 years, with p=0.3. The mean Fasting Blood Sugar (FBS) was significantly higher in patients with NPDR than in those without DR (199.76±65.47 vs. 177.69±62.75, p<0.031*). Similarly, the mean HbA1c level was higher in patients with DR compared to those without (9.77±2.27 vs. 8.71±1.97, p=0.002*). A statistically significant association was found between the level of Low-density Lipoprotein (LDL) cholesterol and severe NPDR (p=0.03*), but no correlation was found between Fasting Blood Sugar (FBS) and Glycated Haemoglobin (HbA1c) with the lipid profile among type 2 diabetes patients with NPDR and those without DR. Conclusion: A significant association was found between blood glucose, HbA1c, and the duration of diabetes in patients with NPDR and those without DR. Additionally, when NPDR is subcategorised as mild, moderate, and severe, a statistical increase in LDL cholesterol in severe NPDR was observed.