Acta Diabetologica

, Volume 55, Issue 7, pp 681–689 | Cite as

Relationship between serum apolipoproteins levels and retinopathy risk in subjects with type 2 diabetes mellitus

  • Qianjin Zhang
  • Jine Hu
  • Yichuan Hu
  • Ying Ding
  • Jingjing Zhu
  • Changjiang Zhuang
Original Article



Prognostic significance of apolipoproteins in diabetic retinopathy risk has not been well investigated. The aim of this study was to reveal the relationship between the risk of diabetic retinopathy and the levels of several apolipoproteins and their ratios in a 10-year prospective cohort.


A total of 1023 diabetic patients without retinopathy were selected from a 10-year hospital-based diabetic cohort. In this cohort, all subjects had type 2 diabetes. Blood samples were obtained, and serum levels of several apolipoproteins were measured. In the follow-up period, diabetic retinopathy was diagnosed by two ophthalmologists through a series of ophthalmologic examinations. A Cox proportional hazard analysis was adopted to determine the relationship between the risk of diabetic retinopathy and the levels of several apolipoproteins and their ratios.


In the follow-up period, 315 diabetic patients were suffered from diabetic retinopathy, and the remaining 708 patients did not. Baseline serum level of apoAI ≥ 7.4 μmol/L was related to the decreased risk of diabetic retinopathy (HR 0.86, 95% CI 0.70–0.99). Baseline levels of apoCIII ≥ 6.3 μmol/L, apoE ≥ 1.1 μmol/L, apoCIII-to-apoAI ratio ≥ 0.9 and apoE-to-apoAI ratio ≥ 0.2 were associated with the increased risk of this complication (HR 1.25, 95% CI 1.04–1.49; HR 1.23, 95% CI 1.03–1.47; HR 1.34, 95% CI 1.11–1.60; HR 1.21, 95% CI 1.01–1.46).


Elevated level of apoAI might be a protective factor for diabetic retinopathy. Increased levels of apoCIII, apoE, apoCIII-to-apoAI and apoE-to-apoAI ratios might be risk factors for this complication.


Apolipoproteins Diabetes mellitus Diabetic retinopathy Lipids Prognosis 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of human and animal rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Declaration of Helsinki of 1975, as revised in 2008.

Statement of informed consent

Informed consent was obtained from all patients for being included in the study.


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Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2018

Authors and Affiliations

  • Qianjin Zhang
    • 1
  • Jine Hu
    • 1
  • Yichuan Hu
    • 1
  • Ying Ding
    • 1
  • Jingjing Zhu
    • 1
  • Changjiang Zhuang
    • 1
  1. 1.Department of EndocrinologyShuyang People’s HospitalSuqian CityChina

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