Abstract
BackgroundErythropoietin (EPO) is one of the systemic angiogenic factors, and its role in ocular angiogenesis and in diabetic retinopathy (DR) is not yet fully understood. The latest research data reveal a possible correlation of higher erythropoietin concentrations in the blood and in the eye with the development of more advanced stages of DR.The main aim of this work was to examine the possible influence of serum concentrations of erythropoietin on the development of diabetic retinopathy in patients with diabetes mellitus type 2.MethodsThe research involved 90 patients examined at the University Eye Clinic of the Clinical Center of Vojvodina, Novi Sad, Serbia. The first group comprised 60 patients with diabetes mellitus lasting for 10 years or more, with diabetic retinopathy. The second, control group consisted of 30 healthy individuals. In the first group of 60 patients with diabetes, 30 of them had non-proliferative diabetic retinopathy (NPDR), and 30 had proliferative diabetic retinopathy (PDR). Laboratory EPO serum levels were determined, and they were correlated to the stage of DR. Concentration of EPO was assessed by ELISA method.ResultsThe highest average concentration of EPO in serum (9.95 mIU/ml) was determined in the group of people with diabetes with PDR. The lowest average concentration of EPO in the serum (6.90 mIU/ml) was found in the control group. The average concentration of EPO in serum in the group of patients with diabetes with NPDR was 7.00 mIU/ml. The EPO concentration in serum was elevated in the group of PDR, and it was directly proportional to the level of the clinical stadium of PDR, being significantly higher in the moderate and severe subgroup of PDR comparing to the control healthy subjects, NPDR and mild PDR (p = 0.007).ConclusionsSignificantly elevated serum concentration of EPO in the advanced stages of DR, and positive correlation between EPO serum concentration and clinical stages of PDR, suggest that erythropoietin represents an important growth factor from blood, which plays a significant role in retinal ischemia and angiogenesis in diabetic retinopathy, especially in the proliferative stage of this disease.
Highlights
Diabetes mellitus (DM) is a multi organic disease with a high incidence in the population, whose main cause is a carbohydrate metabolism disorder
EPO concentration in serum was elevated in group of proliferative diabetic retinopathy (PDR), and it was directly proportional to the level of clinical stadium of PDR, being significantly higher in moderate and severe subgroup of PDR comparing to control healthy subjects, non-proliferative diabetic retinopathy (NPDR) and mild PDR (h=9.858, p=0.007)
Development of diabetic retinopathy (DR) has been studied for decades. lt has been known that local angiogenic factors in the eye are dominant, but many older as well as many recent studies indicate the importance of systemic angiogenic growth factors, too [3,4,5]
Summary
Diabetes mellitus (DM) is a multi organic disease with a high incidence in the population, whose main cause is a carbohydrate metabolism disorder. Changed quality of blood vessels in DM and DR, leads to increased liquid permeability which manifests as bleeding, edema and exudates in the eye. Another key point in DM and DR pathogenesis is ischemia in the tissues, which through production of vasoproliferative, angiogenic factors leads to neovascularization- growth of pathological blood vessels in the eye. These vessels have poor wall quality, and they will lead to circulus vitious of new ischemia attacs and bleeding. One of angiogenic factors is erythropoietin, which is excreted in organism, as a response to tissue hypoxia, with a role to increase erythropoiesis
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
