Three noninvasive methods in the evaluation of subclinical cardiovascular disease in patients with diabetic retinopathy: endothelial dysfunction, serum E-selectin level and monocyte to HDL ratio

Authors : Seyfullah KAN, Adnan KARAİBRAHİMOĞLU

Pages : 36-41

Doi:10.32322/jhsm.640760

View : 15 | Download : 7

Publication Date : 2020-01-15

Article Type : Research Paper

Abstract :ABSTRACT Aim: Cardiovascular risk has increased in diabetic retinopathy insert ignore into journalissuearticles values(DR);. Brachial artery flow mediated dilation insert ignore into journalissuearticles values(FMD); is a non-invasive method used to evaluate endothelial dysfunction. Measurement of adhesion molecules such as E-selectin is the indirect method of predicting endothelial dysfunction. Monocyte/ HDL ratio insert ignore into journalissuearticles values(MHR); is a novel marker found to be related with cardiovascular diseases. In this study, in DR patients without an apparent cardiovascular disease, we aimed to investigate the relation between endothelial dysfunction indicators such as MHR, FMD, E-selectin and subclinical atherosclerosis. Material and Method: In this study, 96 diabetic patients without apparent cardiac symptoms and 32 healthy control patients that matched for gender, age and body mass index insert ignore into journalissuearticles values(BMI); were included. The patients were separated into four groups as; nonproliferative diabetic retinopathy insert ignore into journalissuearticles values(NPDR, n=31);, proliferative diabetic retinopathy insert ignore into journalissuearticles values(PDR, n=32);, diabetic patients without a retinopathy insert ignore into journalissuearticles values(n=33);  and control group insert ignore into journalissuearticles values(n=33);. Anthropometric, biochemical values and FMD were measured. Correlation and regression analysis were done for the relation between MHR and FMD. Results: MHR was significantly high in PDR group insert ignore into journalissuearticles values( p< .001);. E-selectin and FMD which are indicators for endothelial dysfunction were significantly different between groups insert ignore into journalissuearticles values( p< .001 );. E-selectin measures were highest in PDR group, lower in NPDR group, however it was significantly higher than DM and control groups insert ignore into journalissuearticles values( p= .026 );. Inversely proportional to E-selectin, FMD was significantly higher in control and significantly lower in PDR group insert ignore into journalissuearticles values( p< .001 );. Univariate logistic regression method was used to determine factors that had an influence on FMD. Glucose, HbA1C, CRP and MHR had a negative effect. Conclusion: In patients with DR, MHR levels might be used as a novel non-invasive marker to determine early atherosclerotic risk.
Keywords : Diabetic retinopathy, MHR, FMD, , E Selectin