Abstract
Purpose:
A systematic review with meta-analysis, was undertaken to examine the evidence for both qualitative and quantitative associations between dyslipidemia and diabetic macular edema (DME).
Methods:
Medline, Pubmed and Embase electronic databases were searched from inception till November 2013, without language restriction. Eligibility criteria were defined as randomized controlled trials and cohort and case-control studies reporting on the relationships between blood lipid levels and DME. Two independent reviewers examined eligibility and methodological quality of the publications. Both descriptive and quantitative data were extracted systematically.
Results:
The search strategy identified 4705 publications. Following screening 16 articles were selected for review. These included 3 cross-sectional, 6 cohort, 5 case-control and 2 interventional trials. Conventional random effects meta-analysis was performed on only case control studies. Mean levels of total serum cholesterol (TC), serum triglycerides (TG), high density lipoproteins (HDL) and low density lipoproteins (LDL) were significantly higher in DME compared to Diabetics without DME ( TC 48.13 ,95%CI 47.83,48.42 p<0.00001, TG 27.52 95%CI 27.16,27.89 p<0.00001, HDL 1.23 95% CI 0.93,1.52 p<0.00001, and LDL 31.34,95%CI 31.10,31.48 p<0.00001). Qualitative analysis of the other study designs also revealed positive relationships between elevated LDL cholesterol and serum triglycerides and DME.
Conclusions:
Our review strongly supports a role for dyslipidemia in the pathogenesis of DME
Keywords: 505 edema •
498 diabetes •
688 retina