HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Miljanovic, B. Articles by Schaumberg, D. A. Search for Related Content PubMed PubMed Citation Articles by Miljanovic, B. Articles by Schaumberg, D. A. Social Bookmarking                What's this?

A Prospective Study of Serum Lipids and Risk of Diabetic Macular Edema in Type 1 Diabetes

¹ Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
² Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts
³ Diabetes Center, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
⁴ Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
⁵ Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts

We evaluated the relationships between serum lipid levels and clinically significant macular edema (CSME), hard exudates, and other diabetic retinopathy (DR) end points in a population with type 1 diabetes. We studied data from serum lipids that were measured annually among the 1,441 Diabetes Control and Complications Trial (DCCT) participants. We used proportional hazards regression models to examine the relationship of the cumulative average of lipid levels (total, LDL, and HDL cholesterol, total–to–HDL cholesterol ratio, and triglycerides) with development of CSME, hard exudate, DR progression, and development of proliferative DR (PDR). In models controlling for primary prevention versus secondary intervention subgroup, randomized treatment assignment, HbA_1c, and other risk factors, both total–to–HDL cholesterol ratio and LDL predicted development of CSME (rate ratio [RR] for extreme quintiles 3.84, P for trend = 0.03 for total–to–HDL cholesterol ratio, and RR 1.95, P for trend = 0.03 for LDL) and hard exudate (RR 2.44, P for trend = 0.0004 for total–to–HDL cholesterol ratio, and RR 2.77, P for trend = 0.002 for LDL). Relationships of lipids with progression of DR and development of PDR were weaker and not significant after adjustment for HbA_1c. Higher serum lipids are associated with increased risk of CSME and retinal hard exudate. Lipid-lowering treatment among type 1 diabetic subjects, recommended to prevent cardiovascular disease, may also decrease risk of CSME, an important cause of vision loss.

CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				R. Simo, M. Higuera, M. Garcia-Ramirez, F. Canals, J. Garcia-Arumi, and C. Hernandez Elevation of Apolipoprotein A-I and Apolipoprotein H Levels in the Vitreous Fluid and Overexpression in the Retina of Diabetic Patients Arch Ophthalmol, August 1, 2008; 126(8): 1076 - 1081. [Abstract] [Full Text] [PDF]

				Z. T. Bloomgarden Diabetic Retinopathy and Diabetic Neuropathy Diabetes Care, March 1, 2007; 30(3): 760 - 765. [Full Text] [PDF]

				S. Botolin, M.-C. Faugere, H. Malluche, M. Orth, R. Meyer, and L. R. McCabe Increased Bone Adiposity and Peroxisomal Proliferator-Activated Receptor-{gamma}2 Expression in Type I Diabetic Mice Endocrinology, August 1, 2005; 146(8): 3622 - 3631. [Abstract] [Full Text] [PDF]