title: Differential association of serum lipids with diabetic retinopathy and diabetic macular edema.
abstract: OBJECTIVE
  To assess the association of serum lipids with diabetic retinopathy (DR), diabetic macular edema (DME), and macular thickness in adults with diabetes.
  
  
  METHODS
  Diabetic patients aged ≥ 18 years were prospectively recruited from specialized eye clinics in Melbourne, Australia. Fasting total-C (cholesterol), triglyceride, HDL-C, non-HDL-C, and LDL-C were assessed. DR was graded from fundus photographs and classified into mild, moderate, severe nonproliferative, and proliferative DR and separately graded for the presence of DME, including clinically significant macular edema (CSME). Macular thickness was assessed using optical coherence tomography (OCT).
  
  
  RESULTS
  A total of 500 participants (median age, 65 years) were examined. DR, DME, and CSME were present in 321 (66.2%), 149 (33.0%), and 68 (15.0%) patients, respectively. Serum lipid levels were not related to DR or DME. In multivariate models adjusted for traditional risk factors and lipid medications, persons with higher total-, LDL-, and non-HDL-C were more likely to have CSME (odds ratio of 1.54, 1.49, and 1.63 per 1-SD increase, respectively; all P < 0.05). No association was found for serum lipids with macular thickness, as assessed by OCT. The pattern of these associations remained similar in both type 1 and type 2 diabetes, although it was statistically significant only in type 2 diabetes.
  
  
  CONCLUSIONS
  Serum lipids are independently associated with the CSME, but not with DR, mild or moderate DME, or macular thickness. These data reflect the different impact of hyperlipidemia in the pathogenesis of DR and DME and may explain the discrepancies in previous studies.
authors.affiliation: Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia.
authors.forename: Rehab
authors.initials: R
authors.lastname: Benarous
authors.forename: Muhammad B
authors.initials: MB
authors.lastname: Sasongko
authors.forename: Salmaan
authors.initials: S
authors.lastname: Qureshi
authors.forename: Eva
authors.initials: E
authors.lastname: Fenwick
authors.forename: Mohamed
authors.initials: M
authors.lastname: Dirani
authors.forename: Tien Y
authors.initials: TY
authors.lastname: Wong
authors.forename: Ecosse L
authors.initials: EL
authors.lastname: Lamoureux
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood; D003930:Diabetic Retinopathy / Q000097:blood*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008055:Lipids / Q000097:blood*; D008266:Macula Lutea / Q000473:pathology; D008269:Macular Edema / Q000097:blood*; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D041623:Tomography, Optical Coherence; D014280:Triglycerides / Q000097:blood
chemical_list: D001786:Blood Glucose; D002784:Cholesterol; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin; D008055:Lipids; D014280:Triglycerides