Inflammatory Markers and Diabetic Retinopathy in Type 1 Diabetes
- Kenneth E. Izuora, MD1,
- H. Peter Chase, MD1,
- William E. Jackson, MD2,
- Joseph R. Coll, PHD3,
- Iris M. Osberg, MT4,
- Peter A. Gottlieb, MD5,
- Marian J. Rewers, MD, PHD1 and
- Satish K. Garg, MD5
- 1Department of Pediatrics, Barbara Davis Center for Childhood Diabetes, University of Colorado Health Sciences Center, Denver, Colorado
- 2Department of Ophthalmology, University of Colorado Health Sciences Center, Denver, Colorado
- 3Department of Rehabilitation Medicine, University of Colorado Health Sciences Center, Denver, Colorado
- 4Colorado Pediatric General Clinical Research Center, Children’s Hospital, Denver, Colorado
- 5Department of Medicine, University of Colorado Health Sciences Center, Denver, Colorado
- Address correspondence and reprint requests to H. Peter Chase, University of Colorado Health Sciences Center, 4200 East 9th Ave., Box B-140, Denver, CO 8026. E-mail: peter.chase{at}uchsc.edu
Retinopathy affects ∼86% of people in the U.S. with type 1 diabetes (1). This percentage is higher than would be expected as a result of poor glycemic control, blood pressure elevations, and smoking. Another possible risk factor for microvascular disease in type 1 diabetes might be inflammation. Inflammation, as measured by C-reactive protein (CRP), has been shown to be increased in people with type 1 and type 2 diabetes who have macrovascular complications (2–5). A recent study in laboratory animals has suggested that inflammation may be important in the etiology of diabetic retinopathy (6). The purpose of this study was to determine if there was an association between inflammatory markers and diabetic retinopathy.
RESEARCH DESIGN AND METHODS
This was a cross-sectional prospective study comprised of subjects with type 1 diabetes (n = 154) matched by age and sex with nondiabetic control subjects in a 3:1 ratio. Eligible subjects (control subjects and type 1 diabetic patients) were between the ages of 14 and 42 years. Test subjects had type 1 diabetes for >5 years. Subjects were excluded if they had a blood pressure >140/90 mmHg, were tobacco users, were on medications known to affect CRP (ACE inhibitors, hydroxymethylglutaryl CoA reductase inhibitors, nonsteroidal anti-inflammatory agents, and aspirin), had other known concomitant illnesses, or were pregnant. Written informed consent was obtained …
