Correlation Between Diabetic Retinopathy And C-Reactive Protein In Patients With Type 2 Diabetes Mellitus
Main Article Content
Keywords
C-Reactive Protein, Diabetic Retinopathy, Diabetes Mellitus
Abstract
Background: Diabetic Retinopathy (DR) is one of the complications due to diabetes mellitus (DM). Pathogenesis of DR is microvascular disorder because of long term hyperglycemia. The trigger mechanism is activated by metabolic pathways, oxidative stress and inflammation. C-reactive protein (CRP) is one of the inflammatory markers. This study aims to determine the correlation between CRP level and stagging of DR.
Method: This study was a cross-sectional study in Sanglah eye clinic, in August until October 2017, a total of 51 sample with DR. The samples were categorized based on DR staging, namely Non Diabetic Retinopathy (NDR), Non-Proliferative Diabetic Retinopathy (NPDR), and Proliferative Diabetic Retinopathy (PDR) respectively. Each group of staging was performed CRP examination. This study assessed the correlation between CRP levels and staging of DR using Spearman correlation test.
Result: The result of this study obtained correlation coefficient (r) value of 0,396 (p=0,004), showed positive correlation between CRP level and staging Of DR. The regression equation correlation between CRP level and DR staging is expressed by regression equation: CRP = 0,119 + 0,847 (DR staging), this equation shows that if not found DR (NDR=0), CRP level 0,119 mg/L, each 1 staging increase of DR will decrease 0,847 mg/L CRP levels. The correlation between CRP level and DR staging after controlled with independent variables obtained by DR was correlated significantly with DR staging (p=0,037).
Conclusion: This study showed there is positive correlation between plasma CRP levels and the staging of DR, increasing level of CRP correlated with increasing staging of DR.
References
2. Song, J., Chen, S., Liu, X., Duan, H., Kong, J., Li, Z. Relationshhip between C-Reactive Protein Level And Diabetic Retinopathy: A Systemic Review And Meta-Analysis. Plos one.2015: VOL: 10(12)
3. Kulkarni, R.P., Kodliwadmath, M.P. Oxidative Stress and High Senstivity C-Reactive Protein In Diabetic Retinopathy. International Journal of Pharma and Bio Sciences. 2013: 4.p; 1306-1310.
4. American Diabetes Association. Position Statement: Standards of Medical Care in Diabetes 2010. Diab Care, 2010: 33;Suppl.1
5. Yang, X., Deng, Y., Gu, H., Lim, A., Snellingen, T., Liu, X., Wang, N., Domalpally, A., Danis, R., Liu, N. C-Reactive Protein and Diabetic Retinopathy in Chinese Patients with Type 2 Diabetes Mellitus. Int J Ophthalmol. 2017: Vol: 9.p.111-118
6. Mocano, V., Timar, R., Horcat, R., Bucur, A., Serban, V. C-Reactive Protein And Body Mass Index In Patients With Type-2 Diabetes Mellitus And Diabetic Retinopathy. Romanian Journal Of Diabetes Nutritioon And Metabolic Disease. 2013: 20.p; 127-133
7. Stratton, I.M., Adler, A.I., Neil, H.A.W., dkk. Intensive Blood Glucose Control with Sulphonylureas or Insulin Compared with Conventional Treatment and Risk of Complications in Patients with Type 2 Diabetes. Lens Diabetes Journal. 2012: 352;p.837-853
8. Harnett, M.E., Stratton, D.R., Browne, R.W. Serum Markers of Oxidative Stress and Severity of Diabetic Retinopathy. Diabetes Care.2000: 23; p.234-240
9. Wang, F.H., Liang, Y.B., Zhang, F., dkk. Prevalence of diabetic retinopathy in rural China: the Handan eye study. Ophthalmology.2009: .116(3);p.461-467
10. Wong, T.Y., Cheung, N., Tay, W.T., dkk. Prevalence and risk factors for diabetic retinopathy: the Singapore Malay eye study. Ophthalmology. 2008: 115(11);p.1869-1875.
11. Grigsby, J.G., Allen, D.M., Richard, B.C., dkk. The Role of Sex Hormones in Diabetic Retinopathy. Intech. 2012: p.331-56
12. Kastelan, S., Tomic, M., Antunica, G.A., dkk. Body Mass Index: A Risk Factor for Retinopathy in Type 2 Diabetic Patients. Hindawi. 2013;p.1-8
13. Zhang,W., Liu, H., Rojas, M., Caldwell, R.W, and Caldwell, R.B. Anti inflammatory Therapy for Diabetic Retinopathy. Immunotherap. 2011: 5.; 609-628
14. Xu Jie, Du, Kui Fang, dkk. Diabetic Retinopathy in Diabetes Mellitus Patient. Journal of Ophthalmology. 2013: 20;p.24-28
15. Sulaiman, S., Mkthar, A.N., Ismail, Jeriah. Glycemic Control Among Type II Diabetics Patients in Kelatan. NCD Malaysia. 2010: 3(3);p.1-5
16. Zieve, D. Hypertension-Overview. 2012. Available from: http://nlm.nih.gov/medlineplus/ency/anatomyvideos/000072.htm [Accessed: 12 November 2017]
17. Elwali, E.S. et al. Frequency of Diabetic Retinopathy and Associated Risk Factors in Khartoum, Sudan: Population Based Study. Int J Ophthalmol.2017: 10(6). p948-954
18. Kaur, S., Singh, P., Grewal, R.K., Kaur, N., Agarwal, A. Serum Haptoglobin, Ceruplasmin and CRP Levels: Markers of Diabetic Retinopathy. Global journal of Medical Research. 2012: 12; 35-45.
19. Willard, A.L. and Herman, I.M. Vascular complications and diabetes: Current therapies and future challanges. Journal of Ophthalmology. 2012:1-14
20. Peng, D., et al. C-Reactive Protein Genetic Variant is Associated with Diabetic Retinopathy in Chinese Patients with Type 2 Diabetes. BMC Endocrine Disorder. 2015: 15(8)
21. Marshall, G., Garg, S.K., Jackson, W.E., Holmes, D.L., Chase, P. Factors influencing the onset and progression of diabetic retinopathy in subjects with insulin-dependent diabetes mellitus. Ophthalmology. 2003:100; 1133-39
22. Maa, A.Y.,&Sullivan, B.R. Relationship of HbA1c with the Presence and Severity of Retinopathy Upon Initial Screening of Type II Diabetes Mellitus. American Journal of Ophthalmology. 2009:114. p.17-18
23. Nada, W.M., dan Abdel-Moety,A. Serum C-Reactive Protein and Diabetic Retinopathy. Open Journal of Opthalmology. 2017: 7;73-78
24. Pertami, D.I.A. Astaxanthin Menurunkan Kadar Interleukin-6 Plasma pada Non Proliverative Diabetic Retinopathy Ringan: Uji Klinis Terkendali. Medicina. 2014:3; 23 -38.
25. Laksmi, U.N.M., Astaxanthin Menurunkan Kadar Vascular Endothelial Frowth Factor Plasma pada Non Proliverative Diabetic Retinopathy Ringan: Uji Klinis Terkendali. Medicina.2014:4; 20-25.
26. Nanda, K., Sadanand, G., Muralidhara Krishna, C.S., Mahadevappa K.L. C-Reactive Protein as a Predictive Factor of Preeclampsia. Int J Biol Med Res. 2012; 3(1); 1307-1310.
27. Timpson, N.J., et al. C-Reactive Protein Levels and Body Mass Index: Elucidating Direction of Causation Through Reciprocal Mendelian Randomization. Int J Obes. 2011: 35(2);300-308.