Serum apolipoprotein AI and B are stronger biomarkers of diabetic retinopathy than traditional lipids

M.B. Sasongko, T.Y. Wong, T.T. Nguyen, R. Kawasaki, A. Jenkins, J.J. Wang, J. Shaw

Research output: Contribution to journalArticle

74 Citations (Scopus)

Abstract

OBJECTIVE - To describe and compare the associations of serum lipoproteins and apolipoproteins with diabetic retinopathy. RESEARCH DESIGN AND METHODS - This was a cross-sectional study of 224 diabetic patients (85 type 1 and 139 type 2) froma diabetes clinic. Diabetic retinopathy was graded from fundus photographs according to the Airlie House Classification system and categorized into mild, moderate, and vision-threatening diabetic retinopathy (VTDR). Serum traditional lipids (total, LDL, non-HDL, and HDL cholesterol and triglycerides) and apolipoprotein AI (apoAI), apolipoprotein B (apoB), and the apoB-to-apoAI ratio were assessed. RESULTS - Diabetic retinopathy was present in 133 (59.4%) individuals. After adjustment for age, sex, diabetes duration, A1C, systolic blood pressure, and diabetes medications, the HDL cholesterol level was inversely associated with diabetic retinopathy (odds ratio 0.39 [95% CI 0.16-0.94], highest versus lowest quartile; P = 0.017). The ApoAI level was inversely associated with diabetic retinopathy (per SD increase, 0.76 [95% CI 0.59-0.98]), whereas apoB (per SD increase, 1.31 [1.02-1.68]) and the apoB-to-apoAI ratio (per SD increase, 1.48 [1.13-1.95]) were positively associated with diabetic retinopathy. Results were similar for mild to moderate diabetic retinopathy and VTDR. Traditional lipid levels improved the area under the receiver operating curve by 1.8%, whereas apolipoproteins improved the area by 8.2%. CONCLUSIONS - ApoAI and apoB and the apoB-to-apoAI ratio were significantly and independently associated with diabetic retinopathy and diabetic retinopathy severity and improved the ability to discriminate diabetic retinopathy by 8%. Serum apolipoprotein levels may therefore be stronger biomarkers of diabetic retinopathy than traditional lipid measures.
Original languageEnglish
Pages (from-to)474-479
Number of pages6
JournalDiabetes Care
Volume34
Issue number2
DOIs
Publication statusPublished - 01 Feb 2011

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    Sasongko, M. B., Wong, T. Y., Nguyen, T. T., Kawasaki, R., Jenkins, A., Wang, J. J., & Shaw, J. (2011). Serum apolipoprotein AI and B are stronger biomarkers of diabetic retinopathy than traditional lipids. Diabetes Care, 34(2), 474-479. https://doi.org/10.2337/dc10-0793