AIMS/HYPOTHESIS: The exact pathogenesis of retinopathy in diabetic and non-diabetic individuals is incompletely understood, but may involve chronic low-grade inflammation and dysfunction of the vascular endothelium. The aim of this study was to investigate the association of inflammation and endothelial dysfunction with prevalent retinopathy in individuals with and without type 2 diabetes. METHODS: As part of a population-based cohort study, 625 individuals aged 50-74 years, stratified according to age, sex and glucose tolerance status, underwent an extensive physical examination. Retinopathy was assessed by an ophthalmological examination, including funduscopy and two-field 45 degrees fundus photography with mydriasis in both eyes. Levels of C-reactive protein (CRP), soluble intercellular adhesion molecule-1 (sICAM-1), von Willebrand factor, and soluble vascular adhesion molecule-1 (sVCAM-1) were assessed, together with the urinary albumin : creatinine ratio, and the results were combined to obtain summarising z scores for inflammation and endothelial dysfunction. RESULTS: The prevalence of retinopathy was positively associated with tertiles of CRP and sICAM-1. When compared with the lowest tertile, the highest tertile of the inflammatory z score was associated with retinopathy in all subjects (odds ratio [OR]=2.2, 95% CI 1.2-4.1, adjusted for age, sex and glucose tolerance status). The highest tertile of the endothelial dysfunction z score was associated with retinopathy among diabetic individuals (OR=4.4, 95% CI 1.2-15.9, adjusted for age and sex) but not in non-diabetic individuals. Additional adjustment for other risk factors, such as systolic and diastolic blood pressure, BMI, total cholesterol and triglycerides, or mutual adjustment of the inflammatory and endothelial dysfunction z scores did not change the results. CONCLUSIONS/ INTERPRETATION: In this study, inflammatory activity and endothelial dysfunction were associated with retinopathy, which suggests their involvement in the pathogenesis of retinopathy.
AIMS/HYPOTHESIS: The exact pathogenesis of retinopathy in diabetic and non-diabetic individuals is incompletely understood, but may involve chronic low-grade inflammation and dysfunction of the vascular endothelium. The aim of this study was to investigate the association of inflammation and endothelial dysfunction with prevalent retinopathy in individuals with and without type 2 diabetes. METHODS: As part of a population-based cohort study, 625 individuals aged 50-74 years, stratified according to age, sex and glucose tolerance status, underwent an extensive physical examination. Retinopathy was assessed by an ophthalmological examination, including funduscopy and two-field 45 degrees fundus photography with mydriasis in both eyes. Levels of C-reactive protein (CRP), soluble intercellular adhesion molecule-1 (sICAM-1), von Willebrand factor, and soluble vascular adhesion molecule-1 (sVCAM-1) were assessed, together with the urinary albumin : creatinine ratio, and the results were combined to obtain summarising z scores for inflammation and endothelial dysfunction. RESULTS: The prevalence of retinopathy was positively associated with tertiles of CRP and sICAM-1. When compared with the lowest tertile, the highest tertile of the inflammatory z score was associated with retinopathy in all subjects (odds ratio [OR]=2.2, 95% CI 1.2-4.1, adjusted for age, sex and glucose tolerance status). The highest tertile of the endothelial dysfunction z score was associated with retinopathy among diabetic individuals (OR=4.4, 95% CI 1.2-15.9, adjusted for age and sex) but not in non-diabetic individuals. Additional adjustment for other risk factors, such as systolic and diastolic blood pressure, BMI, total cholesterol and triglycerides, or mutual adjustment of the inflammatory and endothelial dysfunction z scores did not change the results. CONCLUSIONS/ INTERPRETATION: In this study, inflammatory activity and endothelial dysfunction were associated with retinopathy, which suggests their involvement in the pathogenesis of retinopathy.
Authors: A Becker; V W M van Hinsbergh; A Jager; P J Kostense; J M Dekker; G Nijpels; R J Heine; L M Bouter; C D A Stehouwer Journal: Eur J Clin Invest Date: 2002-01 Impact factor: 4.686
Authors: C G Schalkwijk; D C Poland; W van Dijk; A Kok; J J Emeis; A M Dräger; A Doni; V W van Hinsbergh; C D Stehouwer Journal: Diabetologia Date: 1999-03 Impact factor: 10.122
Authors: Irene M van der Meer; Moniek P M de Maat; Michiel L Bots; Monique M B Breteler; John Meijer; Amanda J Kiliaan; Albert Hofman; Jacqueline C M Witteman Journal: Arterioscler Thromb Vasc Biol Date: 2002-05-01 Impact factor: 8.311
Authors: Elvis Ojaimi; Thanh T Nguyen; Ronald Klein; F M Amirul Islam; Mary Frances Cotch; Barbara E K Klein; Jie-Jin Wang; Tien Yin Wong Journal: Ophthalmology Date: 2010-11-04 Impact factor: 12.079
Authors: Thanh T Nguyen; Ekaterina Alibrahim; F M Amirul Islam; Ronald Klein; Barbara E K Klein; Mary Frances Cotch; Steven Shea; Tien Y Wong Journal: Diabetes Care Date: 2009-06-23 Impact factor: 19.112
Authors: Thanh T Nguyen; Ryo Kawasaki; Jie Jin Wang; Andreas J Kreis; Jonathan Shaw; Walthard Vilser; Tien Y Wong Journal: Diabetes Care Date: 2009-07-29 Impact factor: 17.152