Influence of serum lipids on clinically significant versus nonclinically significant macular edema: SN-DREAMS Report number 13.
OBJECTIVE
To estimate the prevalence of diabetic macular edema, both clinically significant macular edema (CSME) and nonclinically significant macular edema (non-CSME), and report the associations of dyslipidemia on them.


METHODS
A population-based cross-sectional study in India.


METHODS
After all exclusions, 1414 subjects with diabetes underwent an examination.


METHODS
The CSME was defined according to the Early Treatment Diabetic Retinopathy Study (ETDRS) guidelines; stereo digital fundus pairs were studied. The dyslipidemia cases were classified according to the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III).


METHODS
Prevalence of CSME and non-CSME and association of serum lipids with them.


RESULTS
The prevalence was 31.76% (95% confidence interval [CI], 26.04-37.47) for overall diabetic macular edema, 25.49% (95% Ci, 20.14-30.84) for non-CSME, and 6.27% (95% Ci, 3.29-9.24) for CSME. Univariate analysis identified macroalbuminuria and microalbuminuria, poor glycemic control, high total serum cholesterol, high serum low-density lipoprotein (LDL) cholesterol, and high serum non-high-density lipoprotein (HDL) cholesterol related to non-CSME and CSME (trend chi-square test, P<0.05). Logistic regression analysis (after adjusting variables such as age, gender, body mass index, duration, smoking, hypertension, glycosylated hemoglobin, macroalbuminuria and microalbuminuria, and insulin use) revealed high serum LDL cholesterol (odds ratio [OR], 2.72], high serum non-HDL cholesterol (OR, 1.99), and high cholesterol ratio (OR, 3.08) related to non-CSME, and poor glycemic control (OR, 8.06), microalbuminuria (OR, 14.23), and high serum total cholesterol (OR, 9.09) related to CSME.


CONCLUSIONS
One third of the subjects had diabetic macular edema, and 6% of them showed evidence of CSME necessitating laser photocoagulation.


BACKGROUND
The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Raman
Rajiv
R
Shri Bhagwan Mahavir Vitreoretinal Services, Tamil Nadu, India.
Rani
Padmaja Kumari
PK
Kulothungan
Vaitheeswaran
V
Rachepalle
Sudhir Reddi
SR
Kumaramanickavel
Govindasamy
G
Sharma
Tarun
T
D001786:Blood Glucose / Q000032:analysis; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003430:Cross-Sectional Studies; D003930:Diabetic Retinopathy / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D007194:India / Q000453:epidemiology; D008055:Lipids / Q000097:blood*; D008269:Macular Edema / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D008875:Middle Aged; D015995:Prevalence; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D008055:Lipids; D014280:Triglycerides; D002784:Cholesterol