Dyslipidemia as the Predictive Factor for the Severity of Diabetic Retinopathy among Type 2 Diabetic Patients at KCMC Hospital: A One-year Study

Abstract

Background: Diabetes mellitus (DM) is a global health concern, leading to complications like diabetic retinopathy (DR), a leading cause of blindness. Dyslipidemia, marked by abnormal lipid levels, is considered a risk factor for DR due to its role in endothelial dysfunction and inflammation. However, studies on the relationship between lipid levels and DR severity have yielded conflicting results, making this a debated topic. Study Aim: This study aimed to assess dyslipidemia as a predictor for DR severity in type 2 diabetic patients attending Kilimanjaro Christian Medical Centre (KCMC) from 2023 to 2024. Methodology: A hospital-based analytical cross-sectional study was conducted with 296 diabetic outpatients at KCMC. Participants underwent fundoscopy and were evaluated for DR severity, then blood samples were collected for biochemical analysis. Data were cleaned and analyzed using STATA version 17. Results: Among the patients, 31.4% (93/296) had no DR, while 68.6% (203/296) had DR. Abnormally high levels of serum cholesterol (48.6%), triglycerides (43.6%), LDL (36.1%), and low HDL (38.9%) were identified among study participants.  Elevated serum triglycerides and LDL were significantly associated with DR severity (p < 0.05), while serum cholesterol was not significant after adjustment (p = 0.068). Progression from NPDR to PDR was linked to diabetes duration over 5 years and high serum triglycerides (p ≤ 0.001), but HDL levels were not significantly associated with DR. Abnormal BMI was a significant predictor of diabetic retinopathy (p = 0.002), while urine protein and HbA1c levels were not significant after adjustment. Conclusion: The study found a strong link between dyslipidemia and the severity of DR. Even after adjustments LDL, and triglycerides were significantly associated with DR severity. Diabetes duration and Body mass index were also significant factors. The study emphasizes the importance of early intervention, lifestyle changes, enhanced screening programs, and patient education to manage diabetes and its complications and reduce DR incidence and progression.