Endocrine Abstracts

Introduction: Diabetic retinopathy (DR) is the most common microvascular complication in patients with type 1 diabetes (T1D), and the role of lipids in the development of this complication is still controversial. In this study we have analyzed the association between lipid levels at onset and during the follow-up and the subsequent development of DR.

Methods: The cohort consists of 1132 patients with T1D who were diagnosed in Navarra between 1/1/1990 and 12/21/2016. Information on their LDL-cholesterol, HDL-cholesterol and triglycerides levels was collected at onset and during the follow-up, and the diagnosis of DR was accomplished according to the criteria of the American Academy of Ophthalmology. The results were analyzed using Student-Fisher t test, univariate regression and Cox multivariate regression model.

Results: Comparing the group of patients with T1D who developed DR in relation to those who did not develop it, we observed significantly higher LDL-cholesterol at onset (117.0±60.5 mg/dl vs 109.0±45.8 mg/dl, P=0.002), higher triglycerides (90.5±67.8 mg/dl vs 79.0±60.0 mg/dl, P=0.02); and significantly lower HDL-cholesterol at onset (45.5±22.2 mg/dl vs 49.0±20.0 mg/dl, P=0.05). In the univariate analysis, adjusting for other factors such as age, gender, BMI, smoking habit, blood pressure, and HbA1c or C-peptide levels, we observed that LDL-cholesterol, triglycerides and HDL-cholesterol were significantly associated with the risk of DR throughout follow-up. The multivariate analysis confirmed the results observed in the univariate results in terms of triglycerides: an increase of 10 mg/dl in triglycerides during the follow-up raises the risk of developing DR by 2.9% (HR 1.029 (CI95%: 1.01–1.05), P=0.003). However, the association between HDL-cholesterol and DR in multivariate analysis was only marginally significant (HR 0.91 (CI95%: 0.83–1.00), P=0.058); and the association of LDL-cholesterol with DR development was not significant.

Conclusions: 1) In patients with T1D, lipid profile at onset is a predictor of DR development; 2) high levels of triglycerides can be considered as a risk factor for development of DR in T1D.