LIPOPROTEIN(A) IS A RISK FACTOR FOR DIABETIC-RETINOPATHY IN THE ELDERLY

OBJECTIVE: To assess whether serum lipoprotein(a) is a risk factor for diabetic retinopathy in the elderly. DESIGN: A cross-sectional study. SETTING: Outpatient diabetic clinic. PATIENTS: One hundred four nonin sulin-dependent diabetic patients (35 males, 69 females). Twenty-three were less than 60 years of age (middle-aged), and 81 were 60 years or older (elderly). MEASUREMENT: Levels of lipoprotein(a) (Lp(a)) and li pids were measured in fasting serum. HbA1c was also measured as an ind icator of diabetic control. Other indicators possibly related to retin opathy were also checked. Retinopathy was estimated by photographs of fundi. RESULTS: Significantly higher indicators in the group with reti nopathy than in the group without were: HbA1c, Lp(a), duration of diab etes, and systolic blood pressure (BP) in the total cases; HbA1c, dura tion of diabetes, and Lp(a) in the middle-aged; HbA1c, systolic BP, an d Lp(a) in the elderly. Multiple logistic regression analysis showed t hat only HbA1c and Lp(a) were independent risk factors for retinopathy in all cases and in the elderly. The incidence of retinopathy was pos itively correlated to serum Lp(a) levels. CONCLUSION: Lp(a) is an inde pendent risk factor for diabetic retinopathy.