Serum Apolipoproteins A1 and Apolipoprotein B levels and diabetic retinopathy among diabetic patients attending Kabwohe Health Centre IV Diabetes Clinic, Uganda

Abstract

Abstract Background: Globally, diabetic retinopathy (DR) causes vision loss in people with diabetes and is increasing in Sub-Saharan Africa. Apolipoprotein A1 (Apo A1) and Apolipoprotein B (Apo B), regulators of lipid metabolism, are potential DR biomarkers, but their relevance in Sub-Saharan Africa, including Uganda, is unclear. Objective: This study explored the correlation between serum Apo A1 and Apo B levels and DR among diabetic patients at a rural health center IV. Methodology: A descriptive cross-sectional study was conducted among 190 patients with diabetes. DR was diagnosed by fundoscopy, and laboratory measurements included serum ApoA1, ApoB, lipid profiles, and glycated hemoglobin levels. Descriptive statistics, correlation tests, and a modified Poisson regression analysis were used to identify factors associated with DR and P < 0.05 was considered statistically significant. Results: The prevalence of DR was 18.95%. Apo A1 showed a significant negative correlation with DR ( r = −0.377, P = 0.001), while Apo B had a strong positive correlation with DR ( r = 0.765, P = 0.001). Factors associated with DR included being overweight (adjusted prevalence ratio [aPR]: 1.98, 95% confidence interval [CI]: 1.10–3.56, P = 0.021), poor glycemic control (aPR: 2.38, 95% CI: 1.14–4.99, P = 0.021), being hypertensive (aPR: 1.83, 95% CI: 1.01–3.29, P = 0.043), and triglyceride levels ≥150 mg/dL (aPR: 0.56, 95% CI: 0.33–0.93, P = 0.025). Conclusion: ApoA1 and ApoB are potential biomarkers for early risk stratification. Health education programs should emphasize the importance of regular eye screenings and lifestyle changes. Incorporating apolipoprotein testing into routine diabetic management may enhance DR screening and prevention.