Role of Glycemic Status, Dyslipidemia, and Kidney Function in the Development of Diabetic Retinopathy: A Tertiary Care Hospital-Based Study

Abstract

Background

Diabetic retinopathy is a major microvascular complication of diabetes mellitus and is a major cause of preventable blindness in diabetic patients around the world. The systemic risk factors that are thought to play an important role in the development and progression of DR include poor glycemic control, dyslipidaemia and renal dysfunction.

Aim

To investigate the role of glycemic status, dyslipidaemia and renal function in the onset of diabetic retinopathy in diabetic patients of a tertiary care hospital.

Materials and Methodology

A hospital based cross sectional observational study was conducted over a period of one year in collaboration with the department of Ophthalmology and Biochemistry at a tertiary case hospital.  All 80 diagnosed diabetic patients were included in the study. A detailed clinical history and ophthalmological examination as well as biochemical investigations such as fasting blood glucose, HbA1c, lipid profile, serum creatinine, blood urea, estimated glomerular filtration rate (eGFR), and albuminuria were determined. The classification of diabetic retinopathy was done according to the classical grading systems of ophthalmology. Data was analyzed using SPSS Software and p-value <0.05 was considered as statistically significant.

Results

The age group of 51-60 years old represented the highest number of participants (37.5%) of which 57.5% were males participated in the study. Forty two and a half percent (42.5%) of patients suffered from diabetic retinopathy and mild non-proliferative diabetic retinopathy was the most prevalent stage (20.0%). Poor glycemic control showed significant association with diabetic retinopathy, as 66.7% of patients with HbA1c levels >9% had diabetic retinopathy compared to 16.7% among patients with HbA1c <7% (p <0.001). There was a significant association between elevated triglycerides and LDL cholesterol with diabetic retinopathy (p <0.05). Renal dysfunction was also significantly associated, and the prevalence of diabetic retinopathy in patients with albuminuria and eGFR <60 mL/min were 76.9% and 75.0%, respectively.

Conclusion

The rates of poor glycemic control, dyslipidaemia and renal dysfunction were independently significant in relation to the development of DR. Periodic eye exams and proper metabolic and renal surveillance may aid in earlier detection of high-risk diabetic patients and prevention of vision-threatening complications.