title: Lipids and Diabetic Retinopathy.
abstract: The relationship between lipids and the development and/or severity of diabetic retinopathy (DR) is complex. Large epidemiologic studies suggest an inconsistent and overall modest association between serum triglycerides or major cholesterol species and the severity of DR; however, certain specific lipoprotein species may have stronger associations with DR severity, suggesting a pathophysiological role for lipoproteins analogous to that seen in atherosclerosis. In this lipoprotein-mediated DR pathogenesis model, damage to the blood-retinal barrier allows extravasation of lipoprotein species, which are modified in the intraretinal environment, creating substantial local damage. Additionally, hypolipidemic therapy with statins and fibrates--particularly the latter--have been shown to modulate DR in large-scale studies. Since serum lipid profile changes do not necessarily correlate with DR modulation, the efficacy of these agents may be due to their tissue-specific changes in lipoproteins and/or their anti-inflammatory, antioxidative, antiangiogenic, and antiapoptotic functions.
authors.affiliation: a Retina Service, Department of Ophthalmology , Massachusetts Eye and Ear Infirmary , Boston , Massachusetts , USA .
authors.forename: Bobeck S
authors.initials: BS
authors.lastname: Modjtahedi
authors.affiliation: b Department of Endocrinology , Keck School of Medicine, University of Southern California , Los Angeles , California , USA .
authors.forename: Namrata
authors.initials: N
authors.lastname: Bose
authors.affiliation: a Retina Service, Department of Ophthalmology , Massachusetts Eye and Ear Infirmary , Boston , Massachusetts , USA .
authors.forename: Thanos D
authors.initials: TD
authors.lastname: Papakostas
authors.affiliation: c Department of Ophthalmology and Vision Science , School of Medicine, University of California , Davis , Davis , California , USA , and.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Morse
authors.affiliation: a Retina Service, Department of Ophthalmology , Massachusetts Eye and Ear Infirmary , Boston , Massachusetts , USA .
authors.forename: Demetrios G
authors.initials: DG
authors.lastname: Vavvas
authors.affiliation: d Harvard Medical School , Boston , Massachusetts , USA.
authors.forename: Amar U
authors.initials: AU
authors.lastname: Kishan
mesh_terms: D003930:Diabetic Retinopathy / Q000503:physiopathology*; D011345:Fenofibrate / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006949:Hyperlipidemias / Q000188:drug therapy / Q000503:physiopathology*; D008055:Lipids / Q000502:physiology*
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008055:Lipids; C006012:fenofibric acid; D011345:Fenofibrate
keywords: Diabetic retinopathy; fibrates; lipid metabolism; lipoprotein; statins