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Diabetologia
Published in: Diabetologia 6/2018

Open Access 01-06-2018 | Article

Lp-PLA2 activity is associated with increased risk of diabetic retinopathy: a longitudinal disease progression study

Authors: Moneeza K. Siddiqui, Gwen Kennedy, Fiona Carr, Alexander S. F. Doney, Ewan R. Pearson, Andrew D. Morris, Toby Johnson, Megan M. McLaughlin, Rachel E. Williams, Colin N. A. Palmer

Published in: Diabetologia | Issue 6/2018

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Abstract

Aims/hypothesis

The aim of the study was to examine the association between lipoprotein-associated phospholipase A2 (Lp-PLA2) activity levels and incident diabetic retinopathy and change in retinopathy grade.

Methods

This was a cohort study of diabetic participants with serum collected at baseline and routinely collected diabetic retinal screening data. Participants with type 2 diabetes from the GoDARTS (Genetics of Diabetes Audit and Research in Tayside Scotland) cohort were used. This cohort is composed of individuals of white Scottish ancestry from the Tayside region of Scotland. Survival analysis accounting for informative censoring by modelling death as a competing risk was performed for the development of incident diabetic retinopathy from a disease-free state in a 3 year follow-up period (n = 1364) by stratified Lp-PLA2 activity levels (in quartiles). The same analysis was performed for transitions to more severe grades.

Results

The hazard of developing incident diabetic retinopathy was 2.08 times higher (95% CI 1.64, 2.63) for the highest quartile of Lp-PLA2 activity compared with the lowest. Higher Lp-PLA2 activity levels were associated with a significantly increased risk for transitions to all grades. The hazards of developing observable (or more severe) and referable (or more severe) retinopathy were 2.82 (95% CI 1.71, 4.65) and 1.87 (95% CI 1.26, 2.77) times higher for the highest quartile of Lp-PLA2 activity compared with the lowest, respectively.

Conclusions/interpretation

Higher Lp-PLA2 levels are associated with increased risk of death and the development of incident diabetic retinopathy, as well as transitions to more severe grades of diabetic retinopathy. These associations are independent of calculated LDL-cholesterol and other traditional risk factors. Further, this biomarker study shows that the association is temporally sensitive to the proximity of the event to measurement of Lp-PLA2.
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Metadata
Title
Lp-PLA2 activity is associated with increased risk of diabetic retinopathy: a longitudinal disease progression study
Authors
Moneeza K. Siddiqui
Gwen Kennedy
Fiona Carr
Alexander S. F. Doney
Ewan R. Pearson
Andrew D. Morris
Toby Johnson
Megan M. McLaughlin
Rachel E. Williams
Colin N. A. Palmer
Publication date
01-06-2018
Publisher
Springer Berlin Heidelberg
Published in
Diabetologia / Issue 6/2018
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-018-4601-7

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