Evaluating the role of serum apolipoprotein B to serum apolipoprotein A ratio in type 2Egyptian diabetic patient with retinopathy
Authors: Seddik Hosny Salwa , Samy Nasr Merhan , Hashem Ibrahim Rana , AbdElfattah Moata zM. W , Abdel Dayem Abdel Razek Samar Helmy 
Published: October 2021

Abstract

Background
Diabetes mellitus (DM) has routinely been described as a metabolic disorder characterized by hyperglycemia that develops as a consequence of defects in insulin secretion, insulin action, or both. Type 2 Diabetes encompasses individuals who have insulin resistance (IR) and usually relative (rather than absolute) insulin deficiency. The pathologic hallmark of DM involves the vasculature leading to both micro vascular and macro vascular complications. Diabetic retinopathy (DR) is a chronic progressive, potentially sight-threatening disease of the retinal microvasculature associated with the prolonged hyperglycemia and other conditions linked to diabetes mellitus such as hypertension. Legal blindness due to DR is estimated to be 25 times more common among the diabetic population than in those without diabetes

Objective
To evaluate the role of novel serum lipid markers (serum apolipoprotein B to serum apolipoprotein A ratio) in various grades of diabetic retinopathy .

Methods
This study was conducted on 80 type 2 diabetic patients. Their age between 40-70 years old. There were collected from outpatient ophthalmology clinic at el Demerdash hospital, it was conducted from March to September, 2018. The study was explained to all patients and control subjects, and consent was obtained from them before starting the study. They were subdivided into 3 groups; type 2 diabetic patients with proliferative diabetic retinopathy (group I), type 2 diabetic patients with non-proliferative diabetic retinopathy (group II) and type 2 diabetic patients without retinopathy as control group (group III).

Results
Our results showed that the serum apo B to serum apo A ratio is higher in the diabetic patient with proliferative diabetic retinopathy than the diabetic patient with non-proliferative diabetic retinopathy. Which is higher than the diabetic patient without retinopathy. Drawing attention to the possible relationship between the serum apo B to serum apo A ratio and the progression of diabetic retinopathy.

Conclusion
We found that the serum apo B to serum apo A ratio is higher in the diabetic patient with proliferative diabetic retinopathy than the diabetic patient with non-proliferative diabetic retinopathy. Which is higher than the diabetic patient without retinopathy. Drawing attention to the possible relationship between the serum apo B to serum apo A ratio and the progression of diabetic retinopathy. We found a highly significant difference regarding triglycerides, total cholesterol, Apo B and B/A ratio being higher in diabetic patient with proliferative diabetic retinopathy than diabetic patient with non- proliferative diabetic retinopathy and diabetic patient without retinopathy suggesting the relation between these factors and the progression of diabetic retinopathy. We found that hypertension duration is the most independent factor affecting B/A ratio. So lowering blood pressure can decrease retinopathy progression and improve prognosis in people with type 2 diabetes especially in the first 4- 5 years.