Diabetic retinopathy and serum lipoprotein subclasses in the DCCT/EDIC cohort.
OBJECTIVE
To determine associations between retinopathy status and detailed serum lipoprotein subclass profiles in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study (DCCT/EDIC) cohort.


METHODS
Persons with type 1 diabetes (440 women, 548 men) from the DCCT/EDIC cohort were studied. Retinopathy was characterized by Early Treatment Diabetic Retinopathy Study (ETDRS) scores, hard exudate scores, and ETDRS scores minus the hard exudate component. Lipoproteins were characterized by conventional lipid profile, nuclear magnetic resonance lipoprotein subclass profile (NMR-LSP), apoA1, apoB, lipoprotein(a), and susceptibility of LDL to oxidation. Data were analyzed with and without the following covariates: age, gender, duration of diabetes, HbA(1c), albumin excretion rate (AER), creatinine clearance, hypertension, body mass index, waist-hip ratio, DCCT treatment group, smoking status.


RESULTS
The severity of retinopathy was positively associated with triglycerides (combined cohort) and negatively associated with HDL cholesterol (men, combined cohort). NMR-LSP identified retinopathy as being positively associated with small and medium VLDL and negatively with VLDL size. In men only, retinopathy was positively associated with small LDL, LDL particle concentration, apoB concentration, and small HDL and was negatively associated with large LDL, LDL size, large HDL, and HDL size. No associations were found with apoA1, Lp(a), or susceptibility of LDL to oxidation. All three measures of retinopathy revealed the same associations.


CONCLUSIONS
NMR-LSP reveals new associations between serum lipoproteins and severity of retinopathy in type 1 diabetes. The data are consistent with a role for dyslipoproteinemia involving lipoprotein subclasses in the pathogenesis of diabetic retinopathy.
Section of Endocrinology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA. timothy-lyons@ouhsc.edu
Timothy J
TJ
Lyons
Alicia J
AJ
Jenkins
Deyi
D
Zheng
Daniel T
DT
Lackland
Daniel
D
McGee
W Timothy
WT
Garvey
Richard L
RL
Klein
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D003930:Diabetic Retinopathy / Q000097:blood*; D005260:Female; D006801:Humans; D008075:Lipoproteins, HDL / Q000097:blood* / Q000145:classification; D008077:Lipoproteins, LDL / Q000097:blood* / Q000145:classification; D008079:Lipoproteins, VLDL / Q000097:blood* / Q000145:classification; D009682:Magnetic Resonance Spectroscopy; D008297:Male
D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D008079:Lipoproteins, VLDL