Dyslipidemia and hypertension in patients with type 2 diabetes and retinopathy

Type 2 diabetes is associated with dyslipidemia and higher cardiovascular risk and also generates multiple microvascular complications. Diabetic retinal changes, diabetic maculopathy and proliferative retinopathy are major causes of vision loss among the people of working age worldwide. We searched the association between diabetic retinopathy (as one of the most important long time microvascular complications in diabetes), lipids disorder and blood pressure in subjects with T2DM without known cardiovascular diseases.

We examined 100 patients with type 2 diabetes, without clinical evidence of coronary, cerebrovascular or peripheral artery disease; 48 (48%) were women (mean age 61.23 +/- 8.49) and 52 (52%) were men (mean age 60.75 +/- 8.43). Diabetic retinopathy was graded from retinal photograph according to Early Treatment for Diabetic Retinopathy Study severity scale. In each patient we measured total cholesterol, HDL, LDL, triglycerides. Statistical analysis was performed using Mann-Whitney U-test, Kruskal-Wallis and Oneway Anova tests.

Diabetic retinopathy was found in 59.5% men and 40.5% women. The patients who presented diabetic retinopathy had significantly higher values of total cholesterol (223.05 +/- 42.39 mg/dL vs. 199.84 +/- 45.73 mg/dL) and LDL-C (152.29 +/- 42.46 mg/dL vs. 117.33 +/- 45.35 mg/dL) and smaller HDL-C (38.95 +/- 12.46 mg/dL vs. 48.64 +/- 14.70 mg/dL) as compared to the patients without retinopathy. Although values of triglycerides were higher in the group with retinopathy than in the control one (179.71 +/- 112.60 mg/dL vs. 172.53 +/- 104.53 mg/dL) there were no statistically significant differences.

We found a statistically significant correlation between retinopathy and dyslipidemia, which suggested that the use of systemic lipid lowering therapy in type 2 diabetes is of benefit in patients with retinal changes, in order to prevent visual loss.