%0 Journal Article
%T Inflammation, Haemostatic Disturbance, and Obesity: Possible Link to Pathogenesis of Diabetic Retinopathy in Type 2 Diabetes
%A Martina Tomi£¿
%A Spomenka Ljubi£¿
%A Snje£¿ana Ka£¿telan
%A Antonela Gverovi£¿ Antunica
%A Anamarija Jazbec
%A Tamara Polji£¿anin
%J Mediators of Inflammation
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/818671
%X Purpose. The pathogenesis of diabetic retinopathy (DR) is insufficiently understood but may possibly involve chronic, low-grade inflammation. The aim of this cross-sectional study was to investigate the relationship between inflammatory and haemostatic markers, other markers of endothelial dysfunction and anthropometric parameters, and their association with DR in patients with type 2 diabetes. Methods. According to the DR status patients were divided into three groups: no retinopathy, mild/moderate nonproliferative (NPDR), and severe NPDR/proliferative retinopathy (PDR). Results. The groups did not differ in the levels of inflammatory and haemostatic markers, other markers of endothelial dysfunction, and anthropometric parameters. After dividing the patients according to the level of obesity (defined by BMI, WC, and WHR) into three groups ANOVA showed the differences in C-reactive protein according to the WC ( ) and in fibrinogen according to the WHR ( ) as well as in total cholesterol ( ) and triglycerides ( ) according to the BMI. Logistic regression analyses showed that diabetes duration and prolonged poor glycemic control are the main predictors of retinopathy in patients with type 2 diabetes. Conclusion. Interrelations between obesity, inflammation, haemostatic disturbance, and other risk factors may possibly play an important additional role in endothelial dysfunction involved in the pathogenesis of diabetic retinopathy. 1. Introduction Diabetes is the most frequent endocrine disease in developed countries and one of the most common noncommunicable diseases (NCDs) globally, estimated to have affected more than 371 million people in 2012 and projected to affect 552 million by 2030 [1]. It is the fourth or fifth leading cause of death worldwide with 4.8 million deaths in 2012, and its complications account for a significant portion of morbidity, mortality, and healthcare system cost burdens [1¨C3]. It is undoubtedly one of the most challenging health problems in the 21st century. Diabetes has many manifestations in the eye, of which cataract and diabetic retinopathy are the most significant cause of visual impairment and blindness, and people with diabetes are 25 times more likely than the general population to become blind. Diabetic retinopathy (DR), a long-term microvascular and visually devastating diabetic complication, is estimated to be the leading cause of new blindness in working-aged adults in developed countries [4, 5]. Many epidemiological and clinical trials have proven the impact of diabetes duration, poor glycemic control, and
%U http://www.hindawi.com/journals/mi/2013/818671/