Relevance of the serum apolipoprotein ratio to diabetic retinopathy

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).

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.

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.

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.