Abstract
Purpose :
Dyslipidemia has been identified to incur an increased risk of adverse cardiovascular events. Due to its predictive ability in cardiovascular disease, increased attention has been turned to the prognostic role of abnormal lipid profiles in diabetic retinopathy (DR). This study aims to examine whether abnormal serum levels of various lipid markers affect the risk of developing DR.
Methods :
The TriNetX U.S. Collaborative Network, a HIPAA-compliant, national database based on ICD-10 coding, was queried for diabetic patients with lab results for several lipid markers. The propensity scoring function in TriNetX was used to perform 1:1 matching on age, sex, and race to create groups with normal and abnormal values for comparison. 10-year risk ratios of DR diagnosis in patients without a prior DR diagnosis were calculated using TriNetX to explore how lipid abnormalities impact the risk of DR diagnosis. In patients with a DR diagnosis, 5-year risk ratios of vitreous hemorrhage, tractional retinal detachment, and pars plana vitrectomy coding were calculated to explore how abnormalities may impact DR severity. The index event was considered a patient’s first instance of a lab result.
Results :
The TriNetX national database contained 3,046,622 diabetic patients with at least one lab result. The 10-year relative risk ratio (RRR) of DR diagnosis was significantly increased with low HDL (RRR:1.07, CI:1.06-1.09). In contrast, elevated ApoA-I in male patients (RRR:0.44, CI:0.22-0.88), LDL (RRR:0.68, CI:0.66-0.70), total cholesterol (RRR:0.69, CI:0.67-0.71), and triglycerides (RRR:0.87, CI:0.86-0.89) reduced the 10-year risk of DR diagnosis significantly (Table 1). Elevated LDL and total cholesterol and low HDL in individuals with prior DR diagnosis significantly increased the 5-year risk of vitreous hemorrhage, tractional retinal detachment, and vitrectomy being coded (Table 2).
Conclusions :
This analysis suggests an inverse correlation between serum lipid levels and the risk of DR diagnosis. However, similar aberrations in patients already diagnosed with DR are correlated with a greater risk of DR-related complication diagnoses. Future work will examine differences in baseline factors that may drive these apparently differential effects of serum lipid levels on DR development and progression.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.