LDL levels might influence proliferative diabetic retinopathy

By David Douglas

NEW YORK (Reuters Health) - Serum levels of oxidized low-density lipoprotein (LDL) may be associated with the incidence of proliferative retinopathy in patients with type 1 diabetes, although no significant connection has yet been shown, according to U.S. and Canadian investigators.

Dr. Ronald Klein of the University of Wisconsin, Madison, and colleagues studied fundus photographs of 730 diabetic patients who had been examined up to four times in periods between 1990 and 2014. Levels of LDL collected at each examination were also measured.

After adjusting for the duration of diabetes and other factors, neither the level of oxidized LDL at the beginning of a period nor its subsequent change was significantly associated with the incidence of proliferative diabetic retinopathy, macular edema, or worsening of diabetic retinopathy.

However, Dr. Klein told Reuters Health, although the difference was not significant, the research team did find "an increase in risk for incident proliferative diabetic retinopathy with an increase in the level of oxidized low-density lipoprotein over the preceding period that warrants further investigation."

The findings, reported online July 16 in JAMA Ophthalmology, "need to be replicated," he said.

Commenting by email, Dr. Michael D. Abramoff told Reuters Health that it's already been shown "that high circulating levels of immunocomplexes containing oxidized LDL are associated with initial development of diabetic retinopathy in type 1 diabetes - but not so much with progression of diabetic retinopathy." (He cited, for example, a 2012 paper in Diabetes Care: http://bit.ly/1VlZau7.)

Dr. Abramoff, who is a professor of ophthalmology and visual sciences and a professor of electrical and computer engineering at the University of Iowa Hospital and Clinics, Iowa City, went on to say, "The results of (the current) study show that serum oxidized LDL in isolation is not associated with development or progression of diabetic retinopathy in type 1 diabetes, thus lessening the potential for anti oxidized-LDL agents such as statins to prevent diabetic retinopathy."

The National Institutes of Health and Research to Prevent Blindness supported this research.

SOURCE: http://bit.ly/1IfrH0y

JAMA Ophthalmol 2015.

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