The non-linear link between remnant cholesterol and diabetic retinopathy: a cross-sectional study in patients with type 2 diabetic mellitus

BMC Endocrine Disorders

Research

Yong Han¹  Wushan Pan²  Yongcheng He³  Haofei Hu⁴ 

[1] Department of Emergency, Shenzhen Second People’s Hospital, Guangdong Province, 518000, Shenzhen, China;Department of Emergency, The First Affiliated Hospital of Shenzhen University, Guangdong Province, 518000, Shenzhen, China;Department of Nephrology, Kaifeng Central Hospital, 475000, Kaifeng, Henan Province, China;Department of Nephrology, Shenzhen Hengsheng Hospital, No.3002 Sungang Road, Futian District, 518000, Shenzhen, Guangdong Province, China;Department of Nephrology, Shenzhen Second People’s Hospital, Guangdong Province, 518000, Shenzhen, China;Department of Nephrology, The First Affiliated Hospital of Shenzhen University, Guangdong Province, 518000, Shenzhen, China;

关键词: Diabetic retinopathy;    Proliferative diabetic retinopathy;    Remnant cholesterol;    Cross-sectional study;    Non-linear;    Generalized additive model;   

DOI  :  10.1186/s12902-022-01239-5

 received in 2022-04-06, accepted in 2022-12-06,  发布年份 2022

来源: Springer

【 摘 要 】

ObjectiveResearch on residual cholesterol (RC) and diabetic retinopathy (DR) remains limited. As a result, the current study was designed to investigate the relationship between RC and DR in patients with type 2 diabetic mellitus (T2DM).MethodsThis cross-sectional study consecutively and non-selectively collected a total of 1964 type 2 diabetic mellitus patients in two hospitals in Taiwan from April 2002 to November 2004. A binary logistic regression model was then used to assess the independent relationship between RC level and DR and proliferative diabetic retinopathy (PDR). A generalized additive model (GAM) and smooth curve fitting were used to investigate the actual shape of the curve between them. It was stated that the data had been uploaded to the website:https://journals.plos.org/plosone.ResultsThe average age of the participants was 64.10+/− 11.32 years old, with 42.92% being male. The prevalence of DR and PDR was 35.13 and 18.13%, respectively. The mean RC level was 30.57 ± 14.60 mg/dL. We found no significant association between RC and DR (OR = 1.001; 95% CI 0.991, 1.011) or PDR (OR = 1.008; 95% CI 0.995, 1.021) based on a fully adjusted logistic regression model. Results remained robust across a series of sensitivity analyses. However, a non-linear relationship was detected between RC and DR. Using a two-piece logistic regression model and a recursive algorithm, we found an inflection point of RC was 13.0 mg/dL. A 1-unit increase in the RC level was associated with 19.4% greater adjusted odds of DR (OR = 1.194; 95% CI 1.070, 1.333) when RC < 13.0 mg/dL. There was also a non-linear relationship between RC and PDR, and the inflection point of the RC was 39.0 mg/dL. When RC < 39.0 mg/dL, a 1-unit increase in the RC level was associated with 2.1% greater adjusted odds of PDR (OR = 1.021; 95% CI 1.004, 1.038).ConclusionThis study demonstrates a non-linear relationship between RC and DR or PDR in type 2 diabetic mellitus patients. Our findings provide new insights into advancing research on the link between RC and DR or PDR.

【 授权许可】

CC BY   
© The Author(s) 2022

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