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

Year 2020, , 36 - 41, 15.01.2020

Seyfullah Kan , Adnan Karaibrahimoğlu

https://doi.org/10.32322/jhsm.640760

Abstract

ABSTRACT

Aim:
Cardiovascular
risk has increased in diabetic retinopathy (DR). Brachial artery flow mediated
dilation (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
(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 (BMI) were included. The patients were separated into four
groups as; nonproliferative diabetic retinopathy (NPDR, n=31), proliferative
diabetic retinopathy (PDR, n=32), diabetic patients without a retinopathy
(n=33)  and control group (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
(p<.001). E-selectin and FMD which
are indicators for endothelial dysfunction were significantly different between
groups (p< .001). E-selectin measures
were highest in PDR group, lower in NPDR group, however it was significantly
higher than DM and control groups (p=
.026). Inversely proportional to E-selectin, FMD was significantly higher
in control and significantly lower in PDR group (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

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