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Background <p>Diabetic retinopathy (DR) is a major microvascular complication of diabetes mellitus and a leading cause of visual impairment. While dyslipidemia has been implicated in DR pathogenesis, the relationship between high-density lipoprotein cholesterol (HDL-C) and DR remains controversial. This study aimed to investigate the association between HDL-C levels and DR prevalence in diabetic patients type 2 diabetes mellitus (T2DM).</p> Methods <p>This study is the second analysis based on a cross-sectional studv. A total of 2001 (858 men and 1143 women) diabetic patients who visited the diabetic clinic in the Internal Medicine out-patient departments of two hospitals in southern Taiwan between April 2002 and November 2004. Demographic and clinical data were collected, and serum HDL-C levels were measured. The association between HDL-C and DR was analyzed using multivariate logistic regression, accounting for potential confounders. Additionally, we explored the potential correlation between HDL-C and DR through a smooth curve fitting approach, utilizing a generalized additive model (GAM). and a generalized additive model (GAM).</p> Results <p>Among the 2001 participants, 701 (35.0%) were diagnosed with DR. Our findings demonstrated a significant inverse linear relationship between HDL-C levels and the presence of DR. Higher HDL-C was inversely associated with diabetic retinopathy (DR). In continuous analyses, each 10&#xa0;mg/dL increase in HDL-C corresponded to lower odds of DR across all models, including Model 3 (OR 0.92; 95% CI 0.84–0.99; <i>P</i> = 0.027).Additionally, analysis of HDL-C levels by tertiles revealed that participants in the highest tertile (53.0–99.0&#xa0;mg/dL) had a lower prevalence of DR, with an OR of 0.78 (95% CI: 0.62–0.97; <i>P</i> = 0.029) in Model 1; this association was borderline in Model 2 (OR: 0.80; 95% CI: 0.63–1.01; <i>P</i> = 0.055) and non-significant in Model 3 (OR: 0.86; 95% CI: 0.66–1.09; <i>P</i> = 0.209). In categorical analyses (reference: ≤40&#xa0;mg/dL), participants with HDL-C ≥ 60&#xa0;mg/dL exhibited a significantly lower prevalence of DR in Model 1 (OR: 0.73; 95% CI: 0.56–0.97; <i>P</i> = 0.028), a borderline association in Model 2 (OR: 0.76; 95% CI: 0.57–1.01; <i>P</i> = 0.059), and a non-significant association in Model 3 (OR: 0.83; 95% CI: 0.61–1.14; <i>P</i> = 0.259).</p> Conclusions <p>This study provides evidence of a linear association that elevated HDL-C levels are associated with decreased odds of DR in diabetic patients. Future research should further focus on elucidating the mechanisms underlying this association and its implications for therapeutic strategies.</p>

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The linear association between high-density lipoprotein cholesterol and diabetic retinopathy : a cross-sectional study in diabetic patients

  • 期刊论文

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  • 发表日期：

    2025年10月18日

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  • Zhuolin Xie,
  • Xiangxia Luo,
  • Di Ling,
  • Dongpeng Zhang,
  • Xinglin Chen,
  • Dinghua Zhang,
  • Juan Ling

摘要

Background

Diabetic retinopathy (DR) is a major microvascular complication of diabetes mellitus and a leading cause of visual impairment. While dyslipidemia has been implicated in DR pathogenesis, the relationship between high-density lipoprotein cholesterol (HDL-C) and DR remains controversial. This study aimed to investigate the association between HDL-C levels and DR prevalence in diabetic patients type 2 diabetes mellitus (T2DM).

Methods

This study is the second analysis based on a cross-sectional studv. A total of 2001 (858 men and 1143 women) diabetic patients who visited the diabetic clinic in the Internal Medicine out-patient departments of two hospitals in southern Taiwan between April 2002 and November 2004. Demographic and clinical data were collected, and serum HDL-C levels were measured. The association between HDL-C and DR was analyzed using multivariate logistic regression, accounting for potential confounders. Additionally, we explored the potential correlation between HDL-C and DR through a smooth curve fitting approach, utilizing a generalized additive model (GAM). and a generalized additive model (GAM).

Results

Among the 2001 participants, 701 (35.0%) were diagnosed with DR. Our findings demonstrated a significant inverse linear relationship between HDL-C levels and the presence of DR. Higher HDL-C was inversely associated with diabetic retinopathy (DR). In continuous analyses, each 10 mg/dL increase in HDL-C corresponded to lower odds of DR across all models, including Model 3 (OR 0.92; 95% CI 0.84–0.99; P = 0.027).Additionally, analysis of HDL-C levels by tertiles revealed that participants in the highest tertile (53.0–99.0 mg/dL) had a lower prevalence of DR, with an OR of 0.78 (95% CI: 0.62–0.97; P = 0.029) in Model 1; this association was borderline in Model 2 (OR: 0.80; 95% CI: 0.63–1.01; P = 0.055) and non-significant in Model 3 (OR: 0.86; 95% CI: 0.66–1.09; P = 0.209). In categorical analyses (reference: ≤40 mg/dL), participants with HDL-C ≥ 60 mg/dL exhibited a significantly lower prevalence of DR in Model 1 (OR: 0.73; 95% CI: 0.56–0.97; P = 0.028), a borderline association in Model 2 (OR: 0.76; 95% CI: 0.57–1.01; P = 0.059), and a non-significant association in Model 3 (OR: 0.83; 95% CI: 0.61–1.14; P = 0.259).

Conclusions

This study provides evidence of a linear association that elevated HDL-C levels are associated with decreased odds of DR in diabetic patients. Future research should further focus on elucidating the mechanisms underlying this association and its implications for therapeutic strategies.