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Journal of Medical Sciences

Year: 2005 | Volume: 5 | Issue: 1 | Page No.: 35-42
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Authors

Manal S.Z. Mostafa

Nirvana Samy

Mie Afify

Maha Hashem

Amr Azeb

Keywords

Research Article

Evaluation of Plasma Endothelin-1 and Serum Inflammatory Markers in Patients with Diabetic Retinopathy

Manal S.Z. Mostafa, Nirvana Samy, Mie Afify, Maha Hashem and Amr Azeb
Hyperglycemia has been identified as the major factor for the development of diabetic microvascular complication including retinopathy. Increased expression of Endothelin -1 (ET-1) is associated with diabetic retinopathy and vasculopathy, although the molecular explanation has not been defined. The study was conducted on 55 patients suffering from type 2 diabetes attending the Retina Clinic of Ophthalmology, Research Institute of Ophthalmology, seeking advice as regard eye complications of diabetes. The patients were divided into three groups: Group I included 15 patients who had no retinopathy, Group II including 20 patients with non-proliferative diabetic retinopathy of varying severity and Group III including 20 patients with proliferative diabetic retinopathy. Beside 20 healthy, age and sex matched subjects as a control group. The aim of this study was to examine whether ET-1 plays a role in the progression of diabetic retinopathy in cooperation with the other inflammatory markers. Also to detect the relationship between the stages of diabetic retinopathy and the inflammatory activity by measuring serum IL-6, CRP, haptoglobin and alpha-1 antitrypsin as markers of inflammation. All patients were subjected to the following: detection of plasma levels of glucose and ET-1, serum levels of IL-6, CRP, haptoglobin, α-1 antitrypsin, ALT and AST). The results showed that, the plasma level of ET-1 was increased significantly in-Group II and Group III as compared to the control group and the highest level was detected in-Group III. While, the other inflammatory markers (IL-6, CRP, haptoglobin and α-1 antitrypsin) its serum levels were increased significantly as compared to the control group. There were statistically significant positive correlation (p<0.05) between ET-1 and both of the IL-6 and CRP (r = 0.389 and 0.623, respectively). The best cut off values of ET-1 in Group I was 1.32 pg mL-1 with sensitivity 80% and specificity of 90%, while in Group II the best cut off value was 1.51 pg mL-1 with sensitivity 95% and specificity of 100% and in Group III the best cut off value was 1.63 pg mL-1 with sensitivity 100% and specificity of 100%. The positive and the negative predictive values in the three studied groups were (90.9 and 82.6, 100 and 95.24 and 100 and 100%, respectively). In conclusion, ET-1 plays some role in the development of retinopathy in diabetic patients in cooperation with the markers of inflammation and may be helpful to predict the presence of proliferative diabetic retinopathy in patients with diabetes mellitus. Thus identifying and treating markers for vascular disease in diabetes is significant in preventing long-term disabilities and containing health care costs, also it recommended to maintain normal blood glucose levels in diabetes patients, as blood glucose that is elevated for several years is a major factor in the development and progression of microvascular disease complications.
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