Diabetes Care, Vol 15, Issue 4 552-555, Copyright © 1992 by American Diabetes Association
Vascular endothelial cell antibodies in diabetic patients. Association with diabetic retinopathy
DB Jones, R Wallace and BM Frier
Department of Medicine, Royal Infirmary, Edinburgh, United Kingdom.
OBJECTIVE--To determine the incidence of antiendothelial cell antibodies in
diabetic patients with and without retinopathy. RESEARCH DESIGN AND
METHODS--The study consisted of 70 insulin-dependent diabetic (IDDM)
subjects, 36 non-insulin-dependent diabetic (NIDDM) subjects, and 40
nondiabetic control subjects. Blood samples were obtained from diabetic
patients and control subjects and patients with background and
proliferative retinopathy were identified. RESULTS--Vascular endothelial
cell (VEC) antibodies were examined in the sera of 36 NIDDM subjects, 70
IDDM subjects, and 40 nondiabetic control subjects by indirect
immunofluorescence. VEC antibodies were present in 5 of 40 (12%) control
subjects, 7 of 23 (30%) newly diagnosed IDDM patients, 6 of 17 (35%) IDDM
patients without retinopathy, 12 of 18 (67%) IDDM patients with background
retinopathy (P less than 0.05), and 9 of 12 (75%) IDDM patients with
proliferative retinopathy (P less than 0.01). Three of 13 (23%) NIDDM
patients with retinopathy and 6 of 23 (26%) without retinopathy were VEC
antibody positive. No associations were observed between the presence of
VEC antibodies and either the quality of glycemic control or the duration
of diabetes. A significant association between VEC antibodies and
large-vessel disease was found in IDDM patients with retinopathy (P less
than 0.05). CONCLUSIONS--Antibodies directed against vascular endothelial
cells may play a role in the development of microvascular, and possibly
macrovascular, disease in diabetes.