Clinical Ophthalmology (Jun 2024)

Nonlinear Relationship Between Low Density Lipoprotein and the Probability of Diabetic Macular Edema

  • Yao Y,
  • Lin Z,
  • Ye B,
  • Long T,
  • Li S,
  • Liang H,
  • Luo T,
  • Dou X

Journal volume & issue
Vol. Volume 18
pp. 1717 – 1725

Abstract

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Yufeng Yao,1,2 Zhenli Lin,3 Baikang Ye,1 Tingxi Long,1,4 Suting Li,1,4 Huixian Liang,1,4 Tianyi Luo,1,4 Xiaoyan Dou1 1Department of Ophthalmology, Shenzhen Second People’s Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong Province, People’s Republic of China; 2Shantou University Medical College, Shantou, Guangdong Province, People’s Republic of China; 3Department of Ophthalmology, Shenzhen University General Hospital, Shenzhen, Guangdong Province, People’s Republic of China; 4Shenzhen University Medical College, Shenzhen University, Shenzhen, Guangdong Province, People’s Republic of ChinaCorrespondence: Xiaoyan Dou, Department of Ophthalmology, Shenzhen Second People’s Hospital, The First Affiliated Hospital of Shenzhen University, No. 3002 Sungang West Road, Futian District, Shenzhen, Guangdong Province, 518035, People’s Republic of China, Tel/Fax +86 13600169183, Email [email protected]: Previous studies simply linearized the relationship between low density lipoprotein (LDL) and diabetic macular edema’s (DME) probability, ignoring the possibility of a nonlinear relationship between them. We aimed to investigate the nonlinear relationship between LDL and DME probability in patients with type 2 diabetes mellitus (T2DM).Patients and methods: The study recruited 431 T2DM patients who attended Guangdong Provincial People’s Hospital from December 2017 to November 2018. A multivariate logistic regression model was conducted to evaluate the association between LDL and DME probability. The nonlinear relationship was identified by generalized additive model. Subgroup analyses were performed to assess the consistency of the association in different subgroups.Results: LDL was positively associated with DME probability (OR=1.60, 95% CI: 1.10~2.34, P=0.0145) after adjusting for covariates. A nonlinear relationship between LDL and DME probability was discovered, with an inflection point for LDL around 4.85 mmol/L (95% CI: 4.18~4.93, P=0.037). The effect sizes and the confidence intervals on the left and right sides of inflection point were 2.17 (1.31 to 3.58) and 0.26 (0.04 to 1.77), respectively. Subgroup analyses revealed other variables had no effect on the association between them.Conclusion: Our finding suggested LDL was positively correlated with DME probability in T2DM patients. And the relationship between LDL and DME probability was nonlinear. Our findings need to be confirmed by further causal researches.Keywords: low density lipoprotein, diabetic macular edema, nonlinearity, association

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