title: Lipoprotein(a) predicts the development of diabetic retinopathy in people with type 2 diabetes mellitus.
abstract: BACKGROUND
  Lipoprotein(a) [Lp(a)] has mainly been considered to be a predictor of the incidence of cardiovascular disease. In addition, previous studies have shown potential linkage between Lp(a) and diabetic microvascular complications.
  
  
  OBJECTIVE
  We investigated the incidence and risk factors for the development of diabetic retinopathy (DR) in patients with type 2 diabetes.
  
  
  METHODS
  A total of 787 patients with type 2 diabetes without DR were consecutively enrolled and followed up prospectively. Retinopathy evaluation was annually performed by ophthalmologists. The main outcome was new onset of DR.
  
  
  RESULTS
  The median follow-up time was 11.1 years. Patients in the DR group had a longer duration of diabetes (P < .001), higher baseline HbA1c (P < .001), higher albuminuria level (P = .033), and higher level of Lp(a) (P = .005). After adjusting for sex, age, diabetes duration, presence of hypertension, renal function, LDL cholesterol, mean HbA1c, and medications, the development of DR was significantly associated with the serum Lp(a) level (HR 1.57, 95% confidence interval [1.11-2.24]; P = .012, comparing the 4th vs 1st quartile of Lp(a)). The patient group with the highest quartile range of Lp(a) and mean HbA1c levels ≥7.0% had an HR of 5.09 (95% confidence interval [2.63-9.84]; P < .001) for developing DR compared with patients with lower levels of both factors.
  
  
  CONCLUSIONS
  In this prospective cohort study, we demonstrated that the DR was independently associated with the serum Lp(a) level in patients with type 2 diabetes.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Jae-Seung
authors.initials: JS
authors.lastname: Yun
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Tae-Seok
authors.initials: TS
authors.lastname: Lim
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Seon-Ah
authors.initials: SA
authors.lastname: Cha
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Yu-Bae
authors.initials: YB
authors.lastname: Ahn
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Ki-Ho
authors.initials: KH
authors.lastname: Song
authors.affiliation: Department of Ophthalmology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Jin A
authors.initials: JA
authors.lastname: Choi
authors.affiliation: Department of Ophthalmology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Jinwoo
authors.initials: J
authors.lastname: Kwon
authors.affiliation: Department of Ophthalmology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Donghyun
authors.initials: D
authors.lastname: Jee
authors.affiliation: Department of Ophthalmology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Yang Kyung
authors.initials: YK
authors.lastname: Cho
authors.affiliation: Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA.
authors.forename: Yong-Moon
authors.initials: YM
authors.lastname: Park
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. Electronic address: kosh@catholic.ac.kr.
authors.forename: Seung-Hyun
authors.initials: SH
authors.lastname: Ko
mesh_terms: D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003930:Diabetic Retinopathy / Q000097:blood* / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D017270:Lipoprotein(a) / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors
chemical_list: D017270:Lipoprotein(a)
keywords: Diabetic retinopathy; Lipoprotein(a) [Lp(a)]; Type 2 diabetes