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Meta-Analysis
. 2023 Aug 24;12(1):148.
doi: 10.1186/s13643-023-02321-2.

Relationship between dyslipidemia and diabetic retinopathy in patients with type 2 diabetes mellitus: a systematic review and meta-analysis

Zhaoping Li  1 , Yuan Yuan  1 , Qianjin Qi  2 , Qian Wang  1 , Li Feng  3
Affiliations
Meta-Analysis

Relationship between dyslipidemia and diabetic retinopathy in patients with type 2 diabetes mellitus: a systematic review and meta-analysis

Zhaoping Li et al. Syst Rev. .

Abstract

Background: Diabetic retinopathy (DR) affects more than 80% of patients with diabetes. However, literature on the association between serum lipids and DR in patients with type 2 diabetes mellitus (T2DM) is inconsistent. Hence, in this study, we aimed to investigate the relationship between baseline serum lipids and the incidence of DR in patients with T2DM.

Methods: We searched relevant articles in the PubMed, Embase databases, and the Cochrane Library up to February 7, 2022, and reviewed the reference lists of the included articles to identify appropriate cohort studies. The weighted mean difference (WMD) and the corresponding 95% confidence intervals (CIs) were calculated.

Results: Thirteen cohort studies, including 7459 participants, were included in the present study. Higher levels of total cholesterol (2.94 mg/dL, 95% CI 1.32, 4.56), triglycerides (8.13 mg/dL, 95% CI 5.59, 10.66), and low-density lipoprotein cholesterol (2.53 mg/dL, 95% CI 1.02, 4.04) at baseline were observed in patients with later onset of DR. However, no significant difference in the high-density lipoprotein cholesterol level (0.27 mg/dL, 95% CI - 0.91, 1.45) was observed between patients with DR and without DR.

Conclusion: The present results suggest that baseline triglyceride and cholesterol levels are significantly associated with the occurrence of DR in patients with T2DM. Thus, patients with T2DM may benefit from lowering serum lipids. Future studies exploring the relationship between longitudinal changes in serum lipids and DR occurrence are warranted.

Systematic review registration: PROSPERO CRD42022319978.

Keywords: Diabetic retinopathy; Dyslipidemia; Meta-analysis; Type 2 diabetes.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of the literature search and study selection
Fig. 2
Fig. 2
Forest plot of comparing TC levels between the DR population and the control group. WMDs, weighted mean differences; 95% CIs, 95% confidence interval; TC, total cholesterol; DR, diabetic retinopathy
Fig. 3
Fig. 3
Forest plot of comparing TG levels between the DR population and the control group. WMDs, weighted mean differences; 95% CIs, 95% confidence interval; TG, total triglyceride; DR, diabetic retinopathy
Fig. 4
Fig. 4
Forest plot of comparing LDL-C levels between the DR population and the control group. WMDs, weighted mean differences; 95% CIs, 95% confidence interval; LDL-C, low-density lipoprotein cholesterol; DR, diabetic retinopathy
Fig. 5
Fig. 5
Forest plot of comparing HDL-C levels between the DR population and the control group. WMDs, weighted mean differences; 95% CIs, 95% confidence interval; HDL-C, high-density lipoprotein cholesterol; DR, diabetic retinopathy
Fig. 6
Fig. 6
Funnel plots showing the risk of publication bias in the meta-analysis. A Funnel plot of TC. B Funnel plot of TG. C Funnel plot of LDL-C. D Funnel plot of HDL-C. WMDs, weighted mean differences; se, standard error; TC, total cholesterol; TG, total triglyceride; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol
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