A clinical study of correlation of biochemical indices including HDL2/HDL3 ratio with diabetic retinopathy severity status.

Diabetes mellitus (DM) is group of metabolic disorders that share the common phenotype of hyperglycemia caused by complex interaction of genetic and environmental factors and life style choices. Hyperglycemia can occur due to decreased insulin secretion, decreased glucose utilization and increased glucose production. The metabolic dysregulation associated with DM causes secondary pathophysiological changes in multiple organ systems. It’s a leading cause of end stage renal disease, nontraumatic lower limb amputation and adult blindness. DM is classified according to the pathogenic process that leads to hyperglycemia into two broad categories type 1 and type 2. In type 1 DM there is autoimmune destruction of beta cells in pancreas leading to insulin deficiency. Type 2 is characterized by varying degrees of insulin resistance, decrease in insulin production and increase in glucose production. Type 1 usually develops before the age of 30 years while type 2 develops with increasing age. (But 5-10% of cases diagnosed after 30 years of age have immune destruction of beta cells and type 2 can also occur in children especially obese adolescents). Approximately 10% of diabetic population has type 1 DM and majority belong to type 2. CONCLUSIONS From this study we were able to arrive at the following conclusions. 1. Males are affected more than the females i.e. the incidence of diabetic retinopathy is more incident in males as compared to females. 2. In India, prevalence of DR has been reported to range from 10.5% to 26.2% 3. In the clinical profile of the patients , NPDR was more prevalent than PDR. 4. This study shows a correlation with the decreased HDL2/HDL3 ratio with the severity of diabetic retinopathy status. The odds ratio of correlation of HDL2/HDL3 ratio with developing retinopathy in diabetic patients is shown to be 3.76 5. We assessed the HbA1c values in order to assess the control of diabetic status. As a corollary of the above findings , it can be postulated that the severity of diabetic retinopathy status bears a correlation with the level of glycosylated haemoglobin