Retinopathy in non diabetics, diabetic retinopathy and oxidative stress: a new phenotype in Central Africa?

AIM:To evaluate the rates of retinopathy without diabetes and diabetic retinopathy(DR),associated with some markers of oxidative stress,antioxidants and cardiometabolic risk factors.METHODS:We determined the prevalence of DR in 150type 2 diabetes mellitus(T2DM)patients,that of retinopathy in 50 non diabetics,the levels of body mass index(BMI),waist circumference(WC),blood pressure,lipids,8-isoprostane,8-hydroxydeoxyguanosine(8-oHdG),gamma-glutamyl transferase(GGT),oxidized low density lipoprotein(LDL)(OxLDL),thiobarbituric acid reacting substances(TBARS),reduced glutathione(GSH),superoxide dismutase(SOD),uric acid,creatinine,albumin,total antioxidant status(TAOS),zinc,selenium,magnesium,vitamin C,vitamin D,vitamin E,glucose,apolipoprotein B(ApoB).RESULTS:The prevalences of DR at 53y and Rtp at62y were 44%(n=66)and 10%(n=5),respectively.Thehighest levels of 8-isoprostane,8-OHdG,TBARS,SOD,and OxLDL were in DR.The lowest levels of vitamin D,vitamin C,TAOS,and vitamin E were in DR.In the casecontrol study discriminant analysis,the levels of vitamin C,vitamin D,ApoB,8-OHdG,creatinine,Zn,vitamin E,and WC distinguished significantly non-diabetics without DR(controls),T2DM patients without DR and T2DM patients with DR.CONCLUSION:Anticipation of DR onset is significantly associated with the exageration of oxidative stress biomarkers or decrease of antioxidants in African type 2diabetics.Prevention of oxidative stress and abdominal obesity is needed.Supplementation in vitamin C,D,and E should be recommended as complement therapies of T2DM.

Associations of High Density Lipoprotein Cholesterol and Framingham Cardiovascular Risk with Diabetic Retinopathy in African Type 2 Diabetics

Objectives: To assess the associations of high density lipoprotein cholesterol (HDL-C) and Framingham cardiovascular (CVD) with diabetic retinopathy (DR). Methods: A cross-sectional study of random sample of 200 T2DM Central Africans. Sociobiographical, laboratory and eye examination main outcome measures were investigated using Tertiles of HDL-C (stratification = lowest 10% were the significant independent determinants for DR. In the highest HDL-C group, smoking status and 10-year Framingham risk ≥ 10% were the significantly independent determinants for DR. In 10-year Framingham risk ≥ 10% group, smoking status, insulin resistance and increasing levels of HDL-C were the significantly independent determinants for DR. Conclusion: DR and VD remain a public health problem in T2DM Central Africans. Some Central Africans with DR and VD appear to have higher HDL-C than T2DM Central Africans without DR and VD. HDL-C in T2DM patients with DR, may be tightly controlled by genetic factors (black Bantu ethnicity) than the other lipoproteins as reported among Indians, African-Americans, and Japanese individuals. The most preventable environmental risk factors for DR were smoking status, global cardiovascular disease risk, insulin resistance and oxidative stress.