TY - JOUR T1 - 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 AU - Kan, Seyfullah AU - Karaibrahimoğlu, Adnan PY - 2020 DA - January DO - 10.32322/jhsm.640760 JF - Journal of Health Sciences and Medicine JO - J Health Sci Med /JHSM /jhsm PB - MediHealth Academy Yayıncılık WT - DergiPark SN - 2636-8579 SP - 36 EP - 41 VL - 3 IS - 1 LA - en AB - ABSTRACTAim:Cardiovascularrisk has increased in diabetic retinopathy (DR). Brachial artery flow mediateddilation (FMD) is a non-invasive method used to evaluate endothelialdysfunction. Measurement of adhesion molecules such as E-selectin is theindirect method of predicting endothelial dysfunction. Monocyte/ HDL ratio(MHR) is a novel marker found to be related with cardiovascular diseases. Inthis study, in DR patients without an apparent cardiovascular disease, we aimedto investigate the relation between endothelial dysfunction indicators such asMHR, FMD, E-selectin and subclinical atherosclerosis.Materialand Method: In this study, 96 diabetic patients without apparentcardiac symptoms and 32 healthy control patients that matched for gender, ageand body mass index (BMI) were included. The patients were separated into fourgroups as; nonproliferative diabetic retinopathy (NPDR, n=31), proliferativediabetic retinopathy (PDR, n=32), diabetic patients without a retinopathy(n=33) and control group (n=33).Anthropometric, biochemical values and FMD were measured. Correlation andregression analysis were done for the relation between MHR and FMD.Results: MHR was significantly high in PDR group(p<.001). E-selectin and FMD whichare indicators for endothelial dysfunction were significantly different betweengroups (p< .001). E-selectin measureswere highest in PDR group, lower in NPDR group, however it was significantlyhigher than DM and control groups (p=.026). Inversely proportional to E-selectin, FMD was significantly higherin control and significantly lower in PDR group (p< .001). Univariate logistic regression method was used todetermine factors that had an influence on FMD. Glucose, HbA1C, CRP and MHR hada negative effect. Conclusion: In patients with DR, MHR levelsmight be used as a novel non-invasive marker to determine early atheroscleroticrisk. KW - Diabetic retinopathy KW - MHR KW - FMD KW - KW - E-Selectin CR - 1. Davignon J, Ganz P. Role of endothelial dysfunction in atherosclerosis. Circulation 2004; 109(23 Suppl 1): III27-32. CR - 2. Korkmaz H, Onalan O. Evaluation of endothelial dysfunction: flow-mediated dilation. Endothelium 2008; 15(4): 157–63. CR - 3. Libby P, Ridker PM, Hansson GK, Leducq Transatlantic Network on Atherothrombosis. 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