Dr. Himanshu Yadav, Dr. Snigdha Sen, Dr. Meemansha Maheshwari
Abstract: Context The study of correlation of serum lipids and glycosylated haemoglobin and hyperhomocyteinemia in diabetic retinopathy in diabetic retinopathy. Aim To estimate serum lipids and glycosylated haemoglobin levels in patients with and without diabetic retinopathy and to determine correlation between serum lipids and glycosylated haemoglobin levels with the severity of diabetic retinopathy. Setting and design Two year prospective study done in 200 eyes. Material and methods The study included 100 patients with varying grades of diabetic retinopathy and 100 patients without diabetic retinopathy. A detailed history was taken and clinical examination was done and specific investigation were done to estimate HbA1c, blood glucose (fasting and post prandial), Triglycerides, S.HDL, S.LDL, Fundus examination was carried out in all of them. Statistical analysis the data was analysed using students T test and z test. Result Increasing glycosylated haemoglobin levels were associated with increased incidence of diabetic retinopathy and levels were associated with increased progression of diabetic retinopathy from moderate NPDR to severe NPDR. Diabetic patients with retinopathy had a higher mean HbA1c levels as compared to diabetic patients without retinopathy. Increasing serum lipid levels were associated with development but not the severity of diabetic retinopathy. Serum LDL levels in the study group and control group were statistically significant and the results suggest a possible association between hyperhomocyteinemia in diabetic in retinopathy. Conclusion Serum lipid levels are significantly raised in patients with diabetic retinopathy and higher levels are associated with an increased incidence of diabetic retinopathy. Higher serum lipid levels are not associated with more severe retinopathy. Glycosylated haemoglobin is significantly raised in patients with diabetic retinopathy and higher levels are associated with progression from moderate NPDR and severe NPDR and data indicate that hyperhomocytenemia could be an independent risk factor for DR.
Keywords: HbA1c Glycosylated haemoglobin, HDL High density lipoproteins, LDL Low density lipoproteins, NPDR Non proliferative diabetic retinopathy, Hyperhomocyteinemia