EC Ophthalmology

Background: Diabetic retinopathy is the most common and severe microvascular complication of diabetes mellitus. It is the leading cause of irreversible blindness and the prevalence is expected to double by 2030. Comparing biochemical biomarkers in type2 diabetes patients with retinopathy (DR), patients without retinopathy (NDR) and controls.

Method: Study comprised of 3 groups DR (n = 66), NDR (n = 33) and controls (n = 33). Detailed work up included HbA1c levels, blood pressure, hs-CRP (high sensitivity C-reactive protein), white cell count, ESR, BMI, waist circumference.

Results: Mean age was 54yrs. Mean duration of DM was 10 and 4yrs in DR and NDR group. The mean hs-CRP values were significant between diabetics and controls irrespective of the status of retinopathy (p-0.00). For the diabetic population, BMI (body mass index) was positively correlated with CRP (p-0.001). Significance of this relationship was still maintained even after controlling effects of BMI. Amongst the study groups, mean ESR (erythrocyte sedimentation rate) values were higher significantly in diabetes with and without retinopathy than controls and also increased significantly with increasing severity of retinopathy (p-0.00). Patients with PDR (proliferative diabetic retinopathy) had the highest levels of ESR (38.35 ± 12.9).

Conclusion: Our study did not establish any significant relationship between diabetic retinopathy and hs-CRP. Thus, the role of hs-CRP remains controversial.

 Keywords: Diabetes; Diabetic Retinopathy; Non Proliferative Diabetic Retinopathy; Proliferative Diabetic Retinopathy; High Sensitivity C-Reactive Protein; ESR

1. Gao L., et al. “High prevalence of diabetic retinopathy in diabetic patients concomitant with metabolic syndrome”. PLoS One1 (2016): e0145293.
2. Wild S., et al. “Global prevalence of diabetes”. Diabetes Care5 (2004): 1047-1053.
3. Heng LZ., et al. “Diabetic retinopathy: pathogenesis, clinical grading, management and future developments”. Diabetic Medicine6 (2013): 640-650.
4. Antonetti DA., et al. “Diabetic retinopathy”. New England Journal of Medicine 13 (2012): 1227-1239.
5. Rangasamy S., et al. “Diabetic retinopathy and inflammation: novel therapeutic targets”. Middle East African Journal of Ophthalmology 1 (2012): 52-59.
6. Colhoun HM., et al. “C-reactive protein in type 1 diabetes and its relationship to coronary artery calcification”. Diabetes Care10 (2002): 1813-1817.
7. Ayhan Tuzcu E., et al. “Relationship between mean platelet volume and retinopathy in patients with type 2 diabetes mellitus”. Graefe's Archive for Clinical and Experimental Ophthalmology 2 (2014): 237-240.
8. Tang J and Kern TS. “Inflammation in diabetic retinopathy”. Progress in Retinal and Eye Research 5 (2011): 343-358.
9. Powell EU and Field R. “Diabetic retinopathy and rheumatoid arthritis”. Lancet 7349 (1964): 17-18.
10. Genest J. “C-reactive protein: risk factor, biomarker and/or therapeutic target?” Canadian Journal of Cardiology 26 (2010): 41A-44A.
11. Lim LS., et al. “C-reactive protein, body mass index, and diabetic retinopathy”. Investigative Ophthalmology and Visual Science 9 (2010): 4458-4463.
12. Ndumele CE., et al. “Interrelationships between inflammation, C-reactive protein, and insulin resistance”. Journal of the CardioMetabolic Syndrome 3 (2006): 190-196.
13. Gholamhossein Y., et al. “Diabetic retinopathy risk factors: plasma erythropoietin as a risk factor for proliferative diabetic retinopathy”. Korean Journal of Ophthalmology 5 (2014): 373-378.
14. Tsunoda K., et al. “Retinopathy and hypertension affect serum high-sensitivity C-reactive protein levels in Type 2 diabetic patients”. Journal of Diabetes and its Complications 3 (2005): 123-127.
15. Du J-H., et al. “Elevation of serum apelin-13 associated with proliferative diabetic retinopathy in type 2 diabetic patients”. International Journal of Ophthalmology 6 (2014): 968-973.
16. HSCRP - Clinical: C-Reactive Protein, High Sensitivity, Serum.
17. Jia Z., et al. “[Changes of the concentration of serum ischemia modified albumin and high sensitivity C-reactive protein in type 2 diabetic patients with retinopathy]”. Zhonghua Yan Ke Za Zhi9 (2009): 805-808.