High Cholesterol in Diabetes May
Harm Vision
November 30, 2004
Aggressive treatment to lower high cholesterol in patients
with type 1 diabetes, also known as "juvenile diabetes,"
an autoimmune disease that typically develops at a young
age, could protect their vision as well as their cardiovascular
health, a new study suggests.
Harvard researchers found that individuals with the
highest levels of low-density lipoprotein (LDL), the
"bad" cholesterol, had twice the risk of developing
a visual problem called macular edema, or fluid in the
macula of the eye, compared with those with the lowest
LDL levels. Subjects with the highest ratio of total
cholesterol to high-density lipoprotein (HDL), the "good"
cholesterol had a fourfold increased risk of this eye
disorder.
Clinically significant macular edema is the leading
cause of vision loss in diabetics, Dr. Debra A. Schaumberg
of Brigham and Women's Hospital and colleagues note.
While high blood sugar has been tied to the development
and progression of disease of the retina, the relationship
between blood glucose control and clinically significant
macular edema is not as clear.
Schaumberg and her colleagues analyzed data from the
Diabetes Control and Complications Trial, which included
1,441 patients with type 1 diabetes followed for an
average of 6.5 years. Study participants' cholesterol
levels were checked annually.
The study, published in the medical journal Diabetes,
is the largest investigation of its kind to-date to
evaluate the relationship between clinically significant
macular edema and blood cholesterol levels.
Patients in the top quarter of total-to-HDL cholesterol
ratio had 3.84 times the risk of clinically significant
macular edema compared with those in the lowest quarter.
Those with the highest LDL levels were 1.95 more times
likely to develop clinically significant macular edema.
When the patients' blood sugar levels were considered,
the relationship between cholesterol levels and clinically
significant macular edema was weaker, although the association
remained significant.
However, no relationship was seen between cholesterol
levels and the progression or development of diabetic
retinopathy.
The results indicate that high cholesterol, especially
the total-to-HDL cholesterol ratio, are risk factors
for clinically significant macular edema, Schaumberg
and her colleagues conclude. The findings may also lend
further support to current treatment guidelines that
recommend aggressive lowering of high cholesterol in
diabetic patients, they add.
Source:www.reuters.com
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