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Inflammatory, hemostatic, and other novel biomarkers for diabetic retinopathy: the multi-ethnic study of atherosclerosis.

Publication ,  Journal Article
Nguyen, TT; Alibrahim, E; Islam, FMA; Klein, R; Klein, BEK; Cotch, MF; Shea, S; Wong, TY
Published in: Diabetes Care
September 2009

OBJECTIVE: There are conflicting data regarding relationships of systemic biomarkers of inflammation, hemostasis, and homocysteine with diabetic retinopathy. We examined these relationships in the Multi-Ethnic Study of Atherosclerosis. RESEARCH DESIGN AND METHODS: A total of 921 participants with diabetes were included. Diabetic retinopathy was graded from retinal photographs. We defined two outcomes: any diabetic retinopathy and vision-threatening diabetic retinopathy (severe nonproliferative diabetic retinopathy or worse). Systemic markers analyzed were C-reactive protein, homocysteine, fibrinogen, plasmin-alpha(2)-antiplasmin complex (PAP), interleukin-6, d-dimer, factor VIII, serum creatinine, and urinary albumin-to-creatinine (UAC) ratio. RESULTS: Prevalence of diabetic retinopathy was 33.2% and vision-threatening diabetic retinopathy 7.1%. After adjusting for established risk factors (diabetes duration, A1C, systolic blood pressure, waist-to-hip ratio, and use of diabetes medications), fibrinogen (odds ratio 1.14 [95% CI 1.01-1.32], P = 0.05) and PAP (1.25 [1.05-1.50], P = 0.01) were associated with any diabetic retinopathy, while PAP (1.54 [1.13-2.11], P = 0.007) and homocysteine (1.57 [1.16-2.11], P = 0.003) were associated with vision-threatening diabetic retinopathy. Only PAP remained significant after additional adjustment for serum creatinine and UAC ratio. Area under receiver-operator characteristic curve (AUROC) for diabetic retinopathy was constructed for established and novel risk factors. Established risk factors accounted for a 39.2% increase of the AUROC, whereas novel markers (fibrinogen, PAP, homocysteine, serum creatinine, and UAC ratio) only accounted for an additional 2.2%. CONCLUSIONS: There were few associations of novel markers of inflammation, hemostasis, and homocysteine with diabetic retinopathy after controlling for established risk factors. These data suggest that there is limited clinical use of these biomarkers for prediction of diabetic retinopathy.

Duke Scholars

Published In

Diabetes Care

DOI

EISSN

1935-5548

Publication Date

September 2009

Volume

32

Issue

9

Start / End Page

1704 / 1709

Location

United States

Related Subject Headings

  • alpha-2-Antiplasmin
  • Pancreatitis-Associated Proteins
  • Middle Aged
  • Male
  • Interleukin-6
  • Humans
  • Homocysteine
  • Fibrinolysin
  • Fibrin Fibrinogen Degradation Products
  • Female
 

Citation

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Nguyen, T. T., Alibrahim, E., Islam, F. M. A., Klein, R., Klein, B. E. K., Cotch, M. F., … Wong, T. Y. (2009). Inflammatory, hemostatic, and other novel biomarkers for diabetic retinopathy: the multi-ethnic study of atherosclerosis. Diabetes Care, 32(9), 1704–1709. https://doi.org/10.2337/dc09-0102
Nguyen, Thanh T., Ekaterina Alibrahim, FM Amirul Islam, Ronald Klein, Barbara E. K. Klein, Mary Frances Cotch, Steven Shea, and Tien Y. Wong. “Inflammatory, hemostatic, and other novel biomarkers for diabetic retinopathy: the multi-ethnic study of atherosclerosis.Diabetes Care 32, no. 9 (September 2009): 1704–9. https://doi.org/10.2337/dc09-0102.
Nguyen TT, Alibrahim E, Islam FMA, Klein R, Klein BEK, Cotch MF, et al. Inflammatory, hemostatic, and other novel biomarkers for diabetic retinopathy: the multi-ethnic study of atherosclerosis. Diabetes Care. 2009 Sep;32(9):1704–9.
Nguyen, Thanh T., et al. “Inflammatory, hemostatic, and other novel biomarkers for diabetic retinopathy: the multi-ethnic study of atherosclerosis.Diabetes Care, vol. 32, no. 9, Sept. 2009, pp. 1704–09. Pubmed, doi:10.2337/dc09-0102.
Nguyen TT, Alibrahim E, Islam FMA, Klein R, Klein BEK, Cotch MF, Shea S, Wong TY. Inflammatory, hemostatic, and other novel biomarkers for diabetic retinopathy: the multi-ethnic study of atherosclerosis. Diabetes Care. 2009 Sep;32(9):1704–1709.

Published In

Diabetes Care

DOI

EISSN

1935-5548

Publication Date

September 2009

Volume

32

Issue

9

Start / End Page

1704 / 1709

Location

United States

Related Subject Headings

  • alpha-2-Antiplasmin
  • Pancreatitis-Associated Proteins
  • Middle Aged
  • Male
  • Interleukin-6
  • Humans
  • Homocysteine
  • Fibrinolysin
  • Fibrin Fibrinogen Degradation Products
  • Female