C-reactive protein and chitinase 3-like protein 1 as biomarkers of spatial redistribution of retinal blood vessels on digital retinal photography in patients with diabetic retinopathy.

Sonja Predrag Cekic,Milica Pesic,Svetislav Milenkovic,Tatjana Cvetkovic,Gordana Stankovic Babic,Dijana Risimic,Predrag Jovanovic,Ivan Jovanovic

doi:10.17305/bjbms.2014.3.21

Abstract

The aim of the study was to investigate the correlation between the levels of C-reactive protein (CRP) and chitinase 3-like protein 1 (YKL-40) in blood samples with morpohometric parameters of retinal blood vessels in patients with diabetic retinopathy. Blood laboratory examination of 90 patients included the measurement of glycemia, HbA1C, total cholesterol, LDL-C, HDL-C, triglycerides and CRP. Levels of YKL-40 were detected and measured in serum by ELISA (Micro VueYKL-40 EIA Kit, Quidel Corporation, San Diego, USA). YKL-40 correlated positively with diameter and negatively with number of retinal blood vessels. The average number of the blood vessels per retinal zone was significantly higher in the group of patients with mild non-proliferative diabetic retinopathy than in the group with severe form in the optic disc and all five retinal zones. The average outer diameter of the evaluated retinal zones and optic disc vessels was significantly higher in the group with severe compared to the group with mild diabetic retinopathy. Morphological analysis of the retinal vessels on digital fundus photography and correlation with YKL-40 may be valuable for the follow-up of diabetic retinopathy.

Highlights

Diabetic retinopathy (DR) is a microvascular complication of diabetes
In patients with mild DR, FF and fluorescein angiography (FA) showed a small number of stable microaneurysms without leaking, while cotton walls were detected in the group of patients with very severe DR, as well as hemorrhages; microaneurysms were observed in all 4 quadrants of retina, venous bleeding in more than two quadrants and intraretinal vascular abnormalities (IRMAs) in two or more quadrants
Prospective studies suggest that in people with type 1 diabetes, wider retinal venules are associated with progression of mild to more severe levels of retinopathy, including proliferative diabetic retinopathy (PDR) [8]

Summary

Introduction

Diabetic retinopathy (DR) is a microvascular complication of diabetes. It is the leading cause of new cases of blindness among adults. There were more than 382 million people suffering from diabetes in 2013 worldwide [1]. The International Diabetes Federation projected that the number of diabetic patients will reach 592 million in 2035 [1]. It has been reported that about one-third of diabetic patients have sings of DR and about one-tenth of them have vision-threatening retinopathy. Total of 60% of all patients with diabetes mellitus type 2 (DMT2) was diagnosed with DR, and 35% of DR patients progress to proliferative DR and severe vision loss in 10 years, respectively [2]

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