scholarly journals Systemic Erythropoietin Concentration and its Correlation with Stage of Diabetic Retinopathy

2019 ◽  
Author(s):  
Sofija Davidović ◽  
Babić Nikola ◽  
Jovanović Sandra ◽  
Barišić Sava ◽  
Grković Desanka ◽  
...  

Abstract Summary: Background: Erythropoietin (Epo) is one of systemic angiogenic factors, and its role in ocular angiogenesis and in diabetic retinopathy (DR) is not yet fully understood. Latest research data reveal possible correlation of higher EPO concentrations of erythropoietin in blood and in the eye, with more severe of stages of DR. The main aim of this work was to examine the possible influence of serum concentrations of erythropoietin on the development and stages of diabetic retinopathy in patients with diabetes mellitus type 2. Methods: The research involved 90 patients examined at University Eye Clinic in Clinical Center of Vojvodina in Novi Sad, Serbia. First group comprised of 60 patients with diabetes mellitus lasting 10 years or more, with diabetic retinopathy. Second, control group, consisted of 30 healthy individuals. In the first group of 60 diabetic patients, 30 of them had non-proliferative diabetic retinopathy (NPDR), and 30 had proliferative diabetic retinopathy (PDR). Laboratory EPO serum levels were determined, and they were correlated to the stage of DR. Concentration of EPO was assessed by ELISA method at the end of the study. Results: The highest average concentration of EPO in serum (9.95 mIU/ml) was determined in group of diabetics with PDR. The lowest average concentration of EPO in serum (6.90 mIU/ml) was found in control group. The average concentration of Epo in serum in group of diabetics with NPDR was 7.00 mIU/ml. EPO concentration in serum was elevated in group of PDR, and it was directly proportional to the level of clinical stadium of PDR, being significantly higher in moderate and severe subgroup of PDR comparing to control healthy subjects, NPDR and mild PDR (h=9.858, p=0.007). Conclusions: Significantly elevated serum concentration of EPO in advanced stages of DR, and positive correlation between EPO serum concentration and clinical stadium of PDR, suggest that erythropoietin presents one of the important growth factors from blood, which plays role in retinal ischemia and angiogenesis in diabetic retinopathy, especially in the proliferative stage of this disease. Keywords: diabetic retinopathy; erythropoietin; glycated hemoglobin; non-proliferative diabetic retinopathy; proliferative diabetic retinopathy.

2019 ◽  
Author(s):  
Sofija Davidović ◽  
Babić Nikola ◽  
Jovanović Sandra ◽  
Barišić Sava ◽  
Grković Desanka ◽  
...  

Abstract Summary: Background: Erythropoietin (Epo) is one of systemic angiogenic factors, and its role in ocular angiogenesis and in diabetic retinopathy (DR) is not yet fully understood. Latest research data reveal possible correlation of higher EPO concentrations of erythropoietin in blood and in the eye, with more severe of stages of DR. The main aim of this work was to examine the possible influence of serum concentrations of erythropoietin on the development and stages of diabetic retinopathy in patients with diabetes mellitus type 2. Methods: The research involved 90 patients examined at University Eye Clinic in Clinical Center of Vojvodina in Novi Sad, Serbia. First group comprised of 60 patients with diabetes mellitus lasting 10 years or more, with diabetic retinopathy. Second, control group, consisted of 30 healthy individuals. In the first group of 60 diabetic patients, 30 of them had non-proliferative diabetic retinopathy (NPDR), and 30 had proliferative diabetic retinopathy (PDR). Laboratory EPO serum levels were determined, and they were correlated to the stage of DR. Concentration of EPO was assessed by ELISA method at the end of the study. Results: The highest average concentration of EPO in serum (9.95 mIU/ml) was determined in group of diabetics with PDR. The lowest average concentration of EPO in serum (6.90 mIU/ml) was found in control group. The average concentration of Epo in serum in group of diabetics with NPDR was 7.00 mIU/ml. EPO concentration in serum was elevated in group of PDR, and it was directly proportional to the level of clinical stadium of PDR, being significantly higher in moderate and severe subgroup of PDR comparing to control healthy subjects, NPDR and mild PDR (h=9.858, p=0.007). Conclusions: Significantly elevated serum concentration of EPO in advanced stages of DR, and positive correlation between EPO serum concentration and clinical stadium of PDR, suggest that erythropoietin presents one of the important growth factors from blood, which plays role in retinal ischemia and angiogenesis in diabetic retinopathy, especially in the proliferative stage of this disease. Keywords: diabetic retinopathy; erythropoietin; glycated hemoglobin; non-proliferative diabetic retinopathy; proliferative diabetic retinopathy.


2019 ◽  
Author(s):  
Sofija Davidović ◽  
Babić Nikola ◽  
Jovanović Sandra ◽  
Barišić Sava ◽  
Grković Desanka ◽  
...  

Abstract Erythropoietin (EPO) is one of the systemic angiogenic factors, and its role in ocular angiogenesis and in diabetic retinopathy (DR) is not yet fully understood. The latest research data reveal a possible correlation of higher erythropoietin concentrations in the blood and in the eye with the development of more advanced stages of DR. The main aim of this work was to examine the possible influence of serum concentrations of erythropoietin on the development of diabetic retinopathy in patients with diabetes mellitus type 2.Methods The research involved 90 patients examined at the University Eye Clinic of the Clinical Center of Vojvodina, Novi Sad, Serbia. The first group comprised 60 patients with diabetes mellitus lasting for ten years or more, with diabetic retinopathy. The second, control group consisted of 30 healthy individuals. In the first group of 60 patients with diabetes, 30 of them had non-proliferative diabetic retinopathy (NPDR), and 30 had proliferative diabetic retinopathy (PDR). Laboratory EPO serum levels were determined, and they were correlated to the stage of DR. Concentration of EPO was assessed by ELISA method.Results The highest average concentration of EPO in serum (9.95 mIU/ml) was determined in the group of people with diabetes with PDR. The lowest average concentration of EPO in the serum (6.90 mIU/ml) was found in the control group. The average concentration of EPO in serum in the group of patients with diabetes with NPDR was 7.00 mIU/ml. The EPO concentration in serum was elevated in the group of PDR, and it was directly proportional to the level of the clinical stadium of PDR, being significantly higher in the moderate and severe subgroup of PDR comparing to the control healthy subjects, NPDR and mild PDR (p=0.007).Conclusions Significantly elevated serum concentration of EPO in the advanced stages of DR, and positive correlation between EPO serum concentration and clinical stages of PDR, suggest that erythropoietin represents an important growth factor from blood, which plays a significant role in retinal ischemia and angiogenesis in diabetic retinopathy, especially in the proliferative stage of this disease.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Sofija Davidović ◽  
Nikola Babić ◽  
Sandra Jovanović ◽  
Sava Barišić ◽  
Desanka Grković ◽  
...  

Abstract Background Erythropoietin (EPO) is one of the systemic angiogenic factors, and its role in ocular angiogenesis and in diabetic retinopathy (DR) is not yet fully understood. The latest research data reveal a possible correlation of higher erythropoietin concentrations in the blood and in the eye with the development of more advanced stages of DR. The main aim of this work was to examine the possible influence of serum concentrations of erythropoietin on the development of diabetic retinopathy in patients with diabetes mellitus type 2. Methods The research involved 90 patients examined at the University Eye Clinic of the Clinical Center of Vojvodina, Novi Sad, Serbia. The first group comprised 60 patients with diabetes mellitus lasting for 10 years or more, with diabetic retinopathy. The second, control group consisted of 30 healthy individuals. In the first group of 60 patients with diabetes, 30 of them had non-proliferative diabetic retinopathy (NPDR), and 30 had proliferative diabetic retinopathy (PDR). Laboratory EPO serum levels were determined, and they were correlated to the stage of DR. Concentration of EPO was assessed by ELISA method. Results The highest average concentration of EPO in serum (9.95 mIU/ml) was determined in the group of people with diabetes with PDR. The lowest average concentration of EPO in the serum (6.90 mIU/ml) was found in the control group. The average concentration of EPO in serum in the group of patients with diabetes with NPDR was 7.00 mIU/ml. The EPO concentration in serum was elevated in the group of PDR, and it was directly proportional to the level of the clinical stadium of PDR, being significantly higher in the moderate and severe subgroup of PDR comparing to the control healthy subjects, NPDR and mild PDR (p = 0.007). Conclusions Significantly elevated serum concentration of EPO in the advanced stages of DR, and positive correlation between EPO serum concentration and clinical stages of PDR, suggest that erythropoietin represents an important growth factor from blood, which plays a significant role in retinal ischemia and angiogenesis in diabetic retinopathy, especially in the proliferative stage of this disease.


2013 ◽  
Vol 5 (1) ◽  
pp. 28-32 ◽  
Author(s):  
D Karimsab ◽  
SK Razak

Introduction: Normal bacterial flora may be altered by a variety of factors. Objective: To study the aerobic bacterial conjunctival flora in patients with diabetes mellitus and to find its clinical significance by comparing the results to the conjunctival flora of non-diabetic subjects. Materials and methods: A total of 75 diabetic patients were included as cases and 25 nondiabetics as controls to compare the results. Specimens for the study of conjunctival flora were taken by rubbing sterile cotton-tipped swabs to the inferior palbebral conjunctiva. The conjunctival culture report of the patients with diabetic mellitus was compared to that of nondiabetic subjects. Results: Positive conjunctival cultures were seen in a higher percentage of patients with diabetes (unilateral and bilateral positive conjunctival cultures 34.66 % and 58.66 % respectively) compared to that in non-diabetic controls (unilateral and bilateral positive conjunctival cultures 24 % and 16 % respectively). Diabetics showed a higher proportion of coagulase negative staphylococci (45.33 %), compared to the non-diabetic group (16 %). Among the diabetic patients, positive conjunctival cultures were detected more frequently in those with diabetic retinopathy compared to those without retinopathy. A higher proportions of bilateral positive conjunctival cultures were seen in cases with proliferative diabetic retinopathy (38.63 %) in comparison to patients with no retinopathy and different stages of non-proliferative diabetic retinopathy. Conclusion: The conjunctival floral pattern with increased bacteria in diabetics is a predominant cause of many diabetes-related ocular infections. The presence of diabetic retinopathy is an indicator for increased colonization of conjunctiva, and its severity correlates with the severity of diabetic retinopathy. Nepal J Ophthalmol 2013; 5(9):28-32 DOI: http://dx.doi.org/10.3126/nepjoph.v5i1.7818


2014 ◽  
Vol 142 (9-10) ◽  
pp. 529-534 ◽  
Author(s):  
Ivan Sencanic ◽  
Miroslav Stamenkovic ◽  
Vesna Jovanovic ◽  
Sinisa Babovic ◽  
Vesna Jaksic ◽  
...  

Introduction. Ultrastructural changes in corneas of patients with diabetes mellitus have been previously described. Objective. The aim of this study was to compare central corneal thickness (CDR) values in diabetic patients without retinopathy at the stage of diabetic nonproliferative and proliferative retinopathy and CDR in a control group of healthy subjects. Methods. The study included 121 diabetic patients and 125 healthy subjects matched according to gender and age. Each patient underwent ophthalmological examination involving a dilated fundus examination and CDR measurement using the ultrasound pachymeter. The eyes of diabetic patients were classified according to Early Treatment Diabetic Retinopathy Study into three groups: without diabetic retinopathy (NDR), with nonproliferative diabetic retinopathy (NPDR) and a group with proliferative diabetic retinopathy (PDR). Only one eye of each subject was chosen for the study. Results. The mean CDR value was significantly higher in the diabetic group (570.52?31.81 ?m) compared with the control group (541.42?27.82 ?m). The difference between the two groups was statistically significant (p<0.0001). The highest mean CDR value was recorded in the PDR group (585.97?28.58 ?m), followed by the NPDR group (570.84?30.27 ?m), whereas the lowest mean CDR value was recorded in the NDR group (559.80?31.55 ?m). There was a statistically significant difference in CDR between the NDR and PDR groups, as well as between the NPDR and PDR groups (p<0.001, p<0.05 respectively). No significant difference was recorded between the NDR and NPDR groups (p>0.05). Conclusion. CDR of diabetic patients was higher compared to healthy subjects. The highest mean value of CDR was registered in the PDR group, followed by the NPDR and the NDR groups.


Author(s):  
Shipeng Li ◽  
Jianling Sun ◽  
Wenchao Hu ◽  
Yan Liu ◽  
Dan Lin ◽  
...  

Objective Adropin, a newly identified regulatory protein encoded by Enho gene, is correlated with insulin sensitivity and diabetes. The aim of this study is to determine whether serum and vitreous adropin concentrations are correlated with the presence of diabetic retinopathy. Methods A population of 165 patients with type 2 diabetes mellitus (52 without diabetic retinopathy, 69 with non-proliferative diabetic retinopathy and 44 patients with proliferative diabetic retinopathy) was enrolled in this study. The control group enrolled 68 healthy subjects who had underwent vitrectomy for retinal detachment. Serum and vitreous adropin concentrations were examined using enzyme-linked immunosorbent assay method. Results Control subjects had significantly higher serum and vitreous adropin concentrations compared with diabetic patients. Serum and vitreous adropin concentrations in proliferative diabetic retinopathy patients were significantly reduced compared with those in non-proliferative diabetic retinopathy patients and type 2 diabetes mellitus patients without diabetic retinopathy. In addition, there were lower serum and vitreous adropin concentrations in non-proliferative diabetic retinopathy patients compared with type 2 diabetes mellitus patients without diabetic retinopathy. Logistic regression analysis revealed that serum and vitreous adropin were associated with a decreased risk of type 2 diabetes mellitus and diabetic retinopathy. Conclusion Serum and vitreous adropin concentrations are negatively associated with the presence of diabetic retinopathy.


2009 ◽  
Vol 161 (2) ◽  
pp. 345-353 ◽  
Author(s):  
Jakob Triebel ◽  
Michael Huefner ◽  
Giuliano Ramadori

ObjectiveIn vitro experiments and in vivo studies on rodents demonstrate that N-terminal 14, 15, 16, 17, and 18 kDa fragments prolactin-related vasoinhibin (PRL-V) of human PRL are natural inhibitors of neovascularization in the retina and elsewhere. These N-terminal PRL fragments belong to a family of peptides named vasoinhibins, which act as endogenous regulators of angiogenesis and vascular function. These observations led to the hypothesis that PRL-V could play a role in the pathophysiology of diabetic retinopathy in humans. The purpose of this study was to investigate whether patients with diabetes mellitus and diabetic retinopathy have aberrant concentrations of PRL-V in the circulating blood.Research designWe performed a case–control study and developed a new technique to semi-quantitatively determine PRL-V in serum samples from 48 male subjects. The case group consisted of 21 patients with diabetes mellitus and proliferative or non-proliferative diabetic retinopathy. The control group consisted of 27 healthy subjects with no history of diabetes mellitus.MethodsFor the detection of PRL-V, we developed a new analytical method, consisting of immunologic and laser-induced fluorescence techniques.ResultsThe case group had significantly lower PRL-V serum concentrations than the control group (P=0.041). There was no significant difference between patients with proliferative and those with non-proliferative diabetic retinopathy.ConclusionWe conclude that given the antiangiogenic and antivasopermeability actions of PRL-V, the decreased serum levels of PRL-V in patients with diabetes mellitus could contribute to the development and progression of diabetic retinopathy.


2020 ◽  
Vol 17 ◽  
Author(s):  
Van-An Duong ◽  
Jeeyun Ahn ◽  
Na-Young Han ◽  
Jong-Moon Park ◽  
Jeong-Hun Mok ◽  
...  

Background: Diabetic Retinopathy (DR), one of the major microvascular complications commonly occurring in diabetic patients, can be classified into Proliferative Diabetic Retinopathy (PDR) and Non-Proliferative Diabetic Retinopathy (NPDR). Currently available therapies are only targeted for later stages of the disease in which some pathologic changes may be irreversible. Thus, there is a need to develop new treatment options for earlier stages of DR through revealing pathological mechanisms of PDR and NPDR. Objective: The purpose of this study was to characterize proteomes of diabetic through quantitative analysis of PDR and NPDR. Methods: Vitreous body was collected from three groups: control (non-diabetes mellitus), NPDR, and PDR. Vitreous proteins were digested to peptide mixtures and analyzed using LC-MS/MS. MaxQuant was used to search against the database and statistical analyses were performed using Perseus. Gene ontology analysis, related-disease identification, and protein-protein interaction were performed using the differential expressed proteins. Results: Twenty proteins were identified as critical in PDR and NPDR. The NPDR group showed different expressions of kininogen-1, serotransferrin, ribonuclease pancreatic, osteopontin, keratin type II cytoskeletal 2 epidermal, and transthyretin. Also, prothrombin, signal transducer and activator of transcription 4, hemoglobin subunit alpha, beta, and delta were particularly up-regulated proteins for PDR group. The up-regulated proteins related to complement and coagulation cascades. Statherin was down-regulated in PDR and NPDR compared with the control group. Transthyretin was the unique protein that increased its abundance in NPDR compared with the PDR and control group. Conclusion: This study confirmed the different expressions of some proteins in PDR and NPDR. Additionally, we revealed uniquely expressed proteins of PDR and NPDR, which would be differential biomarkers: prothrombin, alpha-2-HS-glycoprotein, hemoglobin subunit alpha, beta, and transthyretin.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Enrico Borrelli ◽  
Domenico Grosso ◽  
Mariacristina Parravano ◽  
Eliana Costanzo ◽  
Maria Brambati ◽  
...  

AbstractThe aim of this study was to measure macular perfusion in patients with type 1 diabetes and no signs of diabetic retinopathy (DR) using volume rendered three-dimensional (3D) optical coherence tomography angiography (OCTA). We collected data from 35 patients with diabetes and no DR who had OCTA obtained. An additional control group of 35 eyes from 35 healthy subjects was included for comparison. OCTA volume data were processed with a previously presented algorithm in order to obtain the 3D vascular volume and 3D perfusion density. In order to weigh the contribution of different plexuses’ impairment to volume rendered vascular perfusion, OCTA en face images were binarized in order to obtain two-dimensional (2D) perfusion density metrics. Mean ± SD age was 27.2 ± 10.2 years [range 19–64 years] in the diabetic group and 31.0 ± 11.4 years [range 19–61 years] in the control group (p = 0.145). The 3D vascular volume was 0.27 ± 0.05 mm3 in the diabetic group and 0.29 ± 0.04 mm3 in the control group (p = 0.020). The 3D perfusion density was 9.3 ± 1.6% and 10.3 ± 1.6% in diabetic patients and controls, respectively (p = 0.005). Using a 2D visualization, the perfusion density was lower in diabetic patients, but only at the deep vascular complex (DVC) level (38.9 ± 3.7% in diabetes and 41.0 ± 3.1% in controls, p = 0.001), while no differences were detected at the superficial capillary plexus (SCP) level (34.4 ± 3.1% and 34.3 ± 3.8% in the diabetic and healthy subjects, respectively, p = 0.899). In conclusion, eyes without signs of DR of patients with diabetes have a reduced volume rendered macular perfusion compared to control healthy eyes.


2021 ◽  
Vol 15 (12) ◽  
pp. 3513-3515
Author(s):  
Bader Alsuwayt

Aim: To describe the rate of the controlled level of glycosylated hemoglobin (HbA1c) among diabetes mellitus patients in Dammam city, Kingdom of Saudi Arabia (KSA). To assess the association between the status of HbA1c and the different patient-related factors namely: insulin use, metformin, dyslipidemia, and statin use. Methods: This cross-sectional study was performed at Security Forces Hospital, Dammam, KSA, between November 2020 and February 2021. A sample of two hundred known diabetic patients who were regularly followed up at the outpatient department (OPD) was selected randomly for the current study. Results: A very low rate (24%) of controlled HbA1C levels in patients with diabetes (type 1 DM and type 2 DM), The data showed that 85 % of all participants in our study are T2DM patients, while only 15% are T1DM patients, Our data showed that patients with dyslipidemia, hypothyroidism, or hypertension have a high level of uncontrolled HbA1C levels. Surprisingly, both dyslipidemia and statin use were predictors of uncontrolled HbA1C, Unexpectedly, non-metformin use has a protective effect toward controlling HbA1C, While insulin use is a strong predictor of uncontrolled HbA1C (OD 5.20). Conclusion: A low rate of controlled glycated hemoglobin (HbA1c) level among patients with diabetes (T1DM and T2DM) in our sample urges the need for immediate intervention to investigate and improve the current findings. Further investigations are needed to fully explain the high rate of uncontrolled HbA1c among insulin, metformin and statins users. Keywords: Glycated hemoglobin, HbA1c, Diabetes mellitus, Statins, Metformin.


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