Lipids and diabetic retinopathy
Julia V. Busik, Physiology, Michigan State University, East Lansing, Michigan, United States
DisclosureBlock: Julia V. Busik, None
Description
Data from recent clinical trials demonstrate that in addition to the well-accepted role of hyperglycemia, dyslipidemia is an important, but often overlooked factor in the development of diabetic retinopathy (DR). Analysis of blood lipid profiles in DCCT samples established a tight association between the development of DR and dyslipidemia in type 1 diabetes, and several clinical trials using lipid-lowering medications, including FIELD and ACCORD Eye suggested a link between dyslipidemia and DR progression in type 2 diabetes. However, unlike macrovascular complications, where the direct correlation between pathology and circulating lipid levels is well established, the role of circulating lipids in microvascular complications is still controversial.
Dyslipidemia is a complex disorder that involves both central, as well as organ-specific mechanisms. These include abnormal levels of lipids in the plasma that arise from a disproportion in metabolism, release and/or uptake by the adipose tissue as well as inefficient lipid removal from blood circulation. In addition to central regulation, most cells in the body have tissue-specific control of lipid uptake, remodeling, and elimination. This presentation will discuss the effects of diabetes on both central and retinal tissue-specific control of multiple lipid classes including fatty acids, triglycerides, cholesterol, and sphingolipids. Potential lipid-specific therapeutic approaches will be addressed.
