Author(s)

Benjamin Longo-Mbenza, Moise Mvitu Muaka, Thierry Gombet, Igor Longo Phemba, Stephen Cook, Emmanuel Mve Mengome

Department of Ophthalmology, University of Kinshasa, Kinshasa, Congo.
Emergency Service, University Hospital Centre, Brazzaville, Congo.
Faculty of Health Sciences, Walter Sisulu University, Mthatha, South Africa.
Faculty of Medicine, University of Health Sciences, Libreville, Gabon.
School of International Studies, Wenzhou Medical College, Wenzhou, China.
The Eye Centre, East London, South Africa.

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 < 40 mg/dL, normal or interdemiate = 40 - 74.9 mg/dL, highest ≥ 75 mg/dL) and Framingham risk stratification (<10% and ≥10%) by logistic regression models. Results: Out of 200 T2DM patients, 120 (35.5%) had DR and out of DR patients, 116 (n = 96.7%) had VD. There was a significant U- shaped relationship between DR rates and HDL-C stratification. In the normal HDL-C group, elevated 8-hydroxydeoxyguanosine and 10-year Framingham risk > 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.

Diabetic Retinopathy, Visual Disability, Higher High Density Lipoprotein, Smoking, Insulin Resistance, Oxidative Stress, Africans

Longo-Mbenza, B. , Muaka, M. , Gombet, T. , Phemba, I. , Cook, S. and Mengome, E. (2014) Associations of High Density Lipoprotein Cholesterol and Framingham Cardiovascular Risk with Diabetic Retinopathy in African Type 2 Diabetics. World Journal of Cardiovascular Diseases, 4, 179-188. doi: 10.4236/wjcd.2014.44026.