Serum Adiponectin Related to Neovascularization Process in Diabetic Retinopathy

Abstract

Introduction:There’s are similar mechanisms in the development of diabetic retinopathy (DR) and diabetic nephropathy (DN) in terms of inflammation and oxidative stress. We wanted to measure serum adiponectin (ADPN) levels in DR, considering the other clinical/laboratory findings in subgroups with or without DN.Methods:A total of 122 patients were included; group 1 (non-diabetic, healthy subjects), group 2 (diabetic without DR, with/without albuminuria/proteinuria), group 3 (mild to moderate DR, without albuminuria/proteinuria) and group 4 (severe non-proliferative or proliferative DR, with albuminuria/proteinuria). DR grades were defined by the same ophthalmologist based on the clinical examination and angiographic findings.Results:In diabetics, mean hemoglobin A1c was over 8.0%. Estimated glomerular filtration rate values and serum albumin levels were significantly lower in group 4 compared to group 1. Not ADPN/C-reactive protein (CRP) levels, but ADPN, ADPN/waist circumference, ADPN/body mass index and ADPN/fibrinogen were all significantly higher in group 4 compared to group 2. ADPN/CRP was positively correlated with high-density cholesterol in group 1, 2, 4, negatively correlated with triglyceride in group 3, 4, and positively correlated with hypertension in group 4.Conclusion:We had increased serum ADPN and indices in the DR neovascularization process among diabetics. But, further loss of kidney function itself prevented the increase in serum ADPN/CRP levels. To estimate progression in the advanced stages of DR, serum ADPN/CRP was a valuable follow-up marker in DR, if there was no urinary loss of ADPN.

Keywords

• adiponectin
• inflammation
• diabetic complications
• neovascularization
• diabetic retinopathy