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Diabetes Care
Year: 2009  |  Volume: 32  |  Issue: 6  |  Page No.: 1098 - 1100

Serum Amyloid A, C-Reactive Protein, and Retinal Microvascular Changes in Hypertensive Diabetic and Nondiabetic Individuals: An Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) substudy

C Stettler, N Witt, R. J Tapp, S Thom, S Allemann, T Tillin, A Stanton, E O`Brien, N Poulter, J. R Gallimore, A. D Hughes and N. Chaturvedi    


To study the association of the inflammatory markers serum amyloid A (SAA) and C-reactive protein (CRP) with retinal microvascular parameters in hypertensive individuals with and without type 2 diabetes.


This cross-sectional analysis was a substudy in 711 patients (159 with and 552 without diabetes) of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) based on digital 30-degree images of superior and inferior temporal retinal fields.


SAA was associated with arteriolar length-to-diameter ratio positively in nondiabetic patients (Ptrend= 0.028) but negatively in diabetic patients (Ptrend= 0.005). The difference was unlikely to be a chance finding (P = 0.007 for interaction). Similar results were found for the association of SAA with arteriolar tortuosity (P = 0.05 for interaction). Associations were less pronounced for CRP and retinal parameters.


Inflammatory processes are differentially involved in retinal microvascular disease in diabetic compared with nondiabetic hypertensive individuals.

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