Association between macular hard exudates and blood lipids in non-proliferative diabetic retinopathyOA

AIM:To investigate the association between dyslipidemia and macular hard exudates(HEs)in non-proliferative diabetic retinopathy(NPDR)secondary to type 2 diabetes mellitus(T2DM).METHODS:NPDR patients attending the outpatient ophthalmology clinic from January 2021 to December 2023 were selected and divided into three groups according to the severity of macular HEs.Group A:None or minimal HEs;Group B:Definite HEs;Group C:Prominent HEs.Total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),lipoprotein(a)[Lp(a)]levels and other lipid-related indicators were routinely measured.The correlation between these indicators and HEs was analyzed.RESULTS:Group A(24 eyes)consisted of 9 males and 15 females with the mean age of 54.71±6.15 y,group B(52 eyes)consisted of 20 males and 32 females with the mean age of 55.08±6.27 y,group C(14 eyes)consisted of 9 males and 5 females with the mean age of 53.93±6.08 y.The concentration of TC,TG,LDL-C and Lp(a)was highest in group C,followed by group B and lowest in group A with statistically significant differences(P<0.001).There were no statistically significant differences between the three groups for fasting plasma glucose(FPG),glycated hemoglobin A1c(HbA1c),creatinine(Cr),and HDL-C(P>0.05).The results of multivariate Logistic regression analysis showed that elevated levels of TC,TG,LDL-C,and Lp(a)were associated with the presence of macular HEs.Receiver operating characteristiccurve analysis showed that the area under the curve(AUC)for TC,TG,LDL-C,Lp(a),and their combination in predicting macular HEs in NPDR were 0.785,0.718,0.784,0.742,and 0.911,respectively,with the combined model demonstrating the highest predictive performance.CONCLUSION:Dyslipidemia is closely associated with the development and progression of macular HEs in patients with NPDR and T2DM.The levels of TC,TG,LDL-C,and Lp(a)were correlated with the severity of macular HEs,suggesting that dyslipidemia may be involved in the pathological process of macular HEs formation.