Table 5.
HDL-C and Diabetic Retinopathy—Epidemiological Links from Observational studies (Selected)
| Author (Year) | Study Design | Study Population | Results/Findings |
|---|---|---|---|
| Sasso et al. (2019) [137] | Cross-sectional | n = 2068 Age > 14 years Individuals in Italy with Type 2 DM |
Diabetic retinopathy was independently associated with HDL-C (OR = 1.042; 95% CI = 1.012–1.109; p-value = 0.004). Adjusted for age, HbA1c and duration of diabetes as potential independent risk factors for DR. |
| Das et al. (2015) [138] | Meta-analysis | 21 relevant articles | HDL-C levels were insignificantly higher in the presence of DME (mean difference between groups = 0.0582 mmol/L; 95%CI = −3.62 × 10−3 to 0.125, p-value = 0.07). |
| Sacks et al. (2014) [126] | Case-control | n = 2535 Age ≥ 40 years 24 sites in 13 countries Adults with Type 2 DM |
Odds ratio for retinopathy associated with a quintile increase of serum HDL-C (≈ 0.2 mmol/L) was insignificant (OR = 0.97; 95% CI = 0.90–1.05; p-value = 0.08). |
| Morton et al. (2012) [139] | Population based prospective cohort | n = 11,140 Age ≥ 55 years Adults with Type 2 DM |
No association between baseline HDL-C and the risk of diabetic retinopathy or any specific type of retinal event. |
| Wong et al. (2008) [132] | Population based Cross-sectional |
n = 3261 Age 40–80 years Adults with diabetes of Malay ethnicity in Singapore |
Insignificant association between low serum HDL-C and retinopathy (OR = 1.18; 95%; CI = 0.62–2.26; p-value = 0.61). |
| Rema et al. (2006) [131] | Population based Cross-sectional |
n = 1736 Age ≥ 20 years Adults with Type 2 DM in Chennai, South India |
No significant difference in serum HDL-C levels in Type 2 DM patients with retinopathy compared with those without retinopathy. |
| Lyons et al. (2004) [134] | Population based Cross-sectional |
n = 988 Age 13–39 years DCCT/EDIC Study Adults in USA |
ETDRS scoring utilized. Measurement of lipoprotein subclass using nuclear magnetic resonance showed that more severe retinopathy was significantly associated with lower HDL-C levels. |
| Miljanovic et al (2004) [129] | Population-based prospective study | n = 1441 Age 13–39 years DCCT/EDIC Study Adults in USA |
Serum HDL-C was not significantly associated with development of CSME. However, higher total–to–HDL cholesterol ratio (RR = 3.84, 95%CI = 1.58–9.36, p-value = 0.03) was significantly associated with higher risk of CSME. |
|
CI, confidence interval; CSME, clinically significant macular edema; DCCT/EDIC, Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications; DM, Diabetes Mellitus; DME, diabetic macular edema; ETDRS, Early Treatment Diabetic Retinopathy Study; HDL-C, high-density lipoprotein cholesterol; HR, hazard ratio; OR, odds ratio; RR, relative risk; SD, standard deviation.
Selected studies are the most recent and relevant. | |||