Associations of High Density Lipoprotein Cholesterol and Framingham Cardiovascular Risk with Diabetic Retinopathy in African Type 2 Diabetics

Abstract

Objectives: To assess the associations of high density lipoprotein cholesterol (HDL-C) and Framingham cardiovascular (CVD) with diabetic retinopathy (DR). Methods: A cross-sectional study of random sample of 200 T2DM Central Africans. Sociobiographical, laboratory and eye examination main outcome measures were investigated using Tertiles of HDL-C (stratification = lowest < 40 mg/dL, normal or interdemiate = 40 -74.9 mg/dL, highest ≥ 75 mg/dL) and Framingham risk stratification (<10% and ≥10%) by logistic regression models. Results: Out of 200 T2DM patients, 120 (35.5%) had DR and out of DR patients, 116 (n = 96.7%) had VD. There was a significant Ushaped relationship between DR rates and HDL-C stratification. In the normal HDL-C group, elevated 8-hydroxydeoxyguanosine and 10-year Framingham risk > 10% were the significant independent determinants for DR. In the highest HDL-C group, smoking status and 10-year Framingham risk ≥ 10% were the significantly independent determinants for DR. In 10-year Framingham risk ≥ 10% group, smoking status, insulin resistance and increasing levels of HDL-C were the significantly independent determinants for DR. Conclusion: DR and VD remain a public health problem in T2DM Central Africans. Some Central Africans with DR and VD appear to have higher HDL-C than T2DM Central Africans without DR and VD. HDL-C in T2DM patients with DR, may be tightly * Corresponding author. B. Longo-Mbenza et al. 180controlled by genetic factors (black Bantu ethnicity) than the other lipoproteins as reported among Indians, African-Americans, and Japanese individuals. The most preventable environmental risk factors for DR were smoking status, global cardiovascular disease risk, insulin resistance and oxidative stress.

Incidence of Diabetic Retinopathy and Its Predictors Among Newly Diagnosed Type 1 and Type 2 Diabetic Patients: A Retrospective Follow-up Study at Tertiary Health-care Setting of Ethiopia

“…The follow-up study regarding the association of HDL-C and incidence was very limited. But a crossectional survey in Democratic Republic of Congo revealed the significant U-shaped relationship between DR rates and HDL-C. 50 In another observational study, a modest association was found for higher levels of HDL-C and decreased prevalence of proliferative DR. 51 The reason could be HDL-C maintains the endothelial cells, and in doing so, prevents atherosclerosis, which is a pathological hallmark of microvascular complications of DM. 52 However, various studies showed insignificant association between DR and HDL-C. 3 , 48 , 53 Unlike the results of our study, findings from “NO BLIND Study Group” reported the novel association between high HDL-C and DR. 54 The contribution of high HDL-C to the pathogenesis of DR is still not clear and the explanation of this association is beyond the scope of this study.…”

Impact of sarcosine on diabetic retinopathy: Findings based on weighted gene co‐expression network analysis and machine learning techniques

“…With the increasing levels of sarcosine, and GlyT‐1 was inhibited, high glycine levels in the synaptic cleft will decrease the expression of NMDARs, 28 especially the expression of NR2B‐containing NMADR subunit 29,30 . Therefore, sarcosine can act as a NR2B antagonist, 36 which may reduce NR2B‐mediated neurotoxicity, apoptosis and cell death, and activate NR2A‐mediated cell survival signalling. One study suggests that inhibition of the NR2B subunit could be a potential therapeutic strategy for some retinal diseases, including retinal ischaemia, DR and glaucoma 34 …”

A Review: Assessment of Hba1c as A Diagnostic Tool in Diabetes Mellitus

“…HbA1c is modified hemoglobin, with glucose linked to the N-terminal valine of the beta chain [9] . It is made in vivo by the non-enzymatic attachment of glucose to hemoglobin [10] .…”