ASSOCIATION OF SERUM C- REACTIVE PROTEIN (CRP), CYSTATIN C AND HOMOCYSTEINE WITH DIABETIC RETINOPATHY IN PATIENTS OF TYPE 2 DIABETES MELLITUS

Abstract

Objective:

The aim of this study was to investigate the association of levels of serum cystatin C (Cys C), CRP and Homocysteine (Hcy) with diabetic retinopathy (DR) associated with type 2 diabetes mellitus and elucidate their clinical prognostic significance.

Material and Methods:

A total of 485 patients of type 2 diabetes were recruited, and their levels of serum cystatin C, Homocysteine (Hcy), and C-reactive protein were measured by using a high sensitivity latex-enhanced immunoturbidimetric method. Type 2 diabetes was diagnosed as per the criteria of the American Diabetes Association 2012 and 1999 World Health Organization. Venepuncture was performed after an overnight fast, and venous blood of all patients was drawn. Fundus fluorescein angiography (FFA) was performed on all patients, and the procedure was carried out by the opthalmologist. Age-related macular degeneration (AMD) was diagnosed by FFA and optical coherence tomography (OCT). All participants were divided into four groups. Group 1 included patients with no Diabetic Retinopathy (NDR) and AMD (n=60, Age 55.1±9.11); Group 2 included patients suffering from Non-Proliferative Diabetic Retinopathy (NPDR) (n=180, Age 56.7±6.21); Group 3 comprised of patients suffering from Proliferative Diabetic Retinopathy (PDR) (n=160, Age 57.1±10.07) and Group 4 consisted of AMD (n=85, exclude patients with NPDR or PDR, Age55.9±6.27).

Results:

Levels of serum CRP, Cys C, and Hcy were significantly distinctive between specific groups. The levels of serum Cys C in the PDR and AMD groups were significantly elevated as compared to NPDR and control groups ( p<0.05,p<0.01, respectively). The levels of serum CRP in the PDR and AMD group were elevated as compared to NPDR and control group (p<0.05, p<0.01 respectively) and the levels of serum Hcy in PDR and AMD group were elevated significantly as compared with NPDR (p<0.01) and control group(p<0.01).

Conclusion:

It is concluded that during the clinical implications of diabetic retinopathy (DR) in patients with type 2 diabetes, the serum levels of C- reactive protein, Cystatin C, and Homocysteine play an important role.