Research article summary (published 30 Aug 2009):

The relation of markers of inflammation and endothelial dysfunction to the prevalence and progression of diabetic retinopathy: Wisconsin epidemiologic study of diabetic retinopathy.

Full Abstract

OBJECTIVE: To determine the relation of glycemia, blood pressure, and serum total cholesterol level as systemic markers of inflammation and endothelial dysfunction to the prevalence and incidence of diabetic retinal outcomes in persons with long-duration type 1 diabetes mellitus. METHODS: Longitudinal population-based study of persons with type 1 diabetes mellitus who received care for their diabetes in south central Wisconsin from July 1, 1979, to June 30, 1980. Data for this investigation were obtained from the 1990-1992 through the 2005-2007 follow-up examinations. Main outcome measures included the severity of diabetic retinopathy (DR) and macular edema (ME). RESULTS: In the 1990-1992 prevalence data, soluble vascular cell adhesion molecule, tumor necrosis factor, and homocysteine levels were associated with increased odds of more severe DR (odds ratios [highest vs lowest quartile], 3.95 [95% confidence interval, 1.66-9.39], 5.46 [2.38-12.52], and 7.46 [2.91-19.16], respectively) in those with kidney disease while controlling for relevant confounders. Similar odds were found for proliferative DR. Only total homocysteine level was associated with increased odds of ME (3.80 [95% confidence interval, 1.91-7.54]), irrespective of kidney disease. None of the markers were associated with incidence of proliferative DR, ME, or progression of DR 15 years later. CONCLUSIONS: A limited number of markers are associated with increased odds of prevalent retinal outcomes in persons with type 1 diabetes mellitus and kidney disease. Only homocysteine level is associated with ME in those with and without kidney disease. In the absence of kidney disease, the markers do not add to the more conventional descriptors and predictors of DR in persons with type 1 diabetes mellitus. This may reflect the close association of DR and kidney disease in diabetic persons.

Author information

Author/s: Klein, Barbara E K (BE); Knudtson, Michael D (MD); Tsai, Michael Y (MY); Klein, Ronald (R);

Affiliation: Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Wisconsin Alumni Research Foundation, Madison, WI 53726, USA. kleinb(-atsign-)epi.ophth.wisc.edu

Grants: EY016379 (Agency:NEI NIH HHS) ; EY03083 (Agency:NEI NIH HHS)

Journal and publication information

Publication Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't

Journal: Archives of ophthalmology (Arch Ophthalmol), published in United States. (Language: eng)

Reference: 2009-Sep; vol 127 (issue 9) : pp 1175-82

Dates: Created 2009/09/15; Completed 2009/09/28;

PMID: 19752427, status: MEDLINE (last retrieval date: 9/28/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult Biological Markers - blood Blood Glucose - analysis Blood Pressure C-Reactive Protein - analysis Cholesterol - blood Cross-Sectional Studies Diabetes Mellitus, Type 1 - blood; epidemiology; physiopathology Diabetic Retinopathy - blood; epidemiology; physiopathology Disease Progression Endothelium, Vascular - pathology Female

Female Follow-Up Studies Hemoglobin A, Glycosylated - analysis Humans Incidence Inflammation - blood Interleukin-6 - blood Macular Edema - blood; epidemiology; physiopathology Male Prevalence Tumor Necrosis Factor-alpha - blood Wisconsin - epidemiology

Associated Chemicals: Biological Markers (0) ; Blood Glucose (0) ; Hemoglobin A, Glycosylated (0) ; IL6 protein, human (0) ; Interleukin-6 (0) ; Tumor Necrosis Factor-alpha (0) ; hemoglobin A1c protein, human (0) ; Cholesterol (57-88-5) ; C-Reactive Protein (9007-41-4)

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