The role of inflammation and endothelial dysfunction in the pathogenesis of diabetic retinopathy.

The pathogenesis of diabetic retinopathy (DR) is insufficiently understood and presumed to possibly involve inflammation and endothelial dysfunction. The aim of the study was to investigate the relationship between inflammation markers, other markers of endothelial dysfunction and anthropometric parameters and their association with DR in patients with type 2 diabetes, divided into three groups: no retinopathy (N = 65), mild/moderate nonproliferative diabetic retinopathy (NPDR; N = 19) and severe NPDR/proliferative diabetic retinopathy (PDR; N = 23). The groups did not differ in the levels of inflammation markers, other markers of endothelial dysfunction and anthropometric parameters. C-reactive protein was correlated with fibrinogen, HbA1c, LDL-cholesterol, BMI, WC, WHR and C index. HbA1c was correlated with cholesterol, LDL-cholesterol, BMI and WC. Logistic regression analysis showed that diabetes duration and HbAlc median were the main predictors of retinopathy. The study demonstrated that the association between obesity, inflammation and other risk factors plays an important role in endothelial impairment involved in the pathogenesis of DR.