The Relationship Between Lipoprotein (a) And Diabetic Retinopathy In Patients With Type2Diabetes Mellitus

Objective:To study the relationship between lipoprotein(a) and diabetic retinopathy in patients with type2diabetes mellitus.Methods:One hundred and thirty-five patients with type2diabetes mellitus(T2DM) who hospitalized in the Department of Endocrinology ward of FujianMedical University Affiliated Union Hospital were selected.All cases were divided into non-diabetic retinopathy(NDR), background diabetic retinopathy(BDR) and proliferative diabetic retinopathy(PDR) according to eye-ground photography,ophthalmofundoscope and fundus fluorescein angiography. Each patient was tested the Lp(a), fasting blood glucose (FBG),2hour plasma glucose(2hPG), glycated hemoglobin (HbA1c) and the parameters of serum lipid metabolism. Clinical data were recorded. Two groups were assessed by using two-sample t-test. The comparison of multi-group was assessed by using analysis of variance and least significant difference t-test.We compared the ranked data by Kruskal-WallisH test and Nemenyi test,and enumeration data by chi-square test. The relationship between Lp(a) and DR was assessed by using spearman rank correlation and the risk factor of DR by using logistic regression analysis.Results:(1) The differences of age, gender, disease duration, BMI, SBP,DBP, MAP,FBG and HBA1c were not statistically significant (P>0.05) amongthree groups.(2) The comparison of serum lipid:①Lp(a) of DR group was higher than NDR group（P<0.01）②We divided DR group into PDR group and BDR group, then we found that Lp(a) of BDR group was higher than NDR gro up（P<0.01） and Lp(a) of PDR group was higher than BDR group（P<0.05）.③The parameters of other serum lipid metabolism were not statistically significant (P>0.05) among three groups.④All cases were divided into three groupsbased on the Lp(a) concentration from low to high,as a result, the degree ofDR increased with the rise of Lp(a) concentration, which showed statisticallysignificant difference (P <0.01).(3) Rank correlation analysis showed that Lp(a)was positively correlated with degree of DR(P<0.01，0<r<1).(4) Regressionanalysis showed that Lp(a) was a independent risk factor for DR.Conclusions: Lp(a) is a independent risk factor for DR and participate in thedevelopment of DR. The level of serum Lp(a) should be paid attention to clinicians.