Serum Amyloid A, C-reactive Protein and Retinal Microvascular Changes in Hypertensive Diabetic and Non-diabetic Individuals: An ASCOT Substudy

  1. Christoph Stettler, MD (christoph.stettler{at}insel.ch)1,2,3,
  2. Nicholas Witt, PhD2,
  3. Robyn J Tapp, PhD2,4,
  4. Simon Thom, FRCP2,
  5. Sabin Allemann, PhD1,3,
  6. Therese Tillin, MSc2,
  7. Alice Stanton, PhD5,
  8. Eoin O'Brien, PhD6,
  9. Neil Poulter, FRCP2,
  10. J Ruth Gallimore, BSc7,
  11. Alun D Hughes, PhD2 and
  12. Nish Chaturvedi, MD2
  1. 1 Division of Endocrinology, Diabetes and Clinical Nutrition, University Hospital and University of Bern, Bern, Switzerland
  2. 2 International Center for Circulatory Health, NHLI, Imperial College, London, UK
  3. 3 Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
  4. 4 International Public Health Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
  5. 5 Molecular and Cellular Therapeutics, RCSI Research Institute, Royal College of Surgeons in Ireland, Dublin, Ireland
  6. 6 Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland
  7. 7 Division of Medicine, Centre for Amyloidosis and Acute Phase Proteins, University College, London, UK

    Abstract

    Objective: To study the association of the inflammatory markers Serum Amyloid A (SAA) and C-reactive protein (CRP) with retinal microvascular parameters in hypertensive individuals with and without type 2 diabetes.

    Research Design and Methods This cross-sectional analysis was a sub-study in 711 patients (159 with, 552 without diabetes) of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) based on digital 30° images of superior and inferior temporal retinal fields.

    Results SAA was associated positively with arteriolar length/diameter ratio in non-diabetic patients (p for trend 0.028) but negatively in diabetic patients (p for trend 0.005). The difference was unlikely to be a chance finding (p=0.007 for interaction). Similar findings resulted for the association of SAA and arteriolar tortuosity (p=0.05 for interaction). Associations were less pronounced for CRP and retinal parameters.

    Conclusions Inflammatory processes are differentially involved in retinal microvascular disease in diabetic compared with non-diabetic hypertensive individuals.

    Footnotes

      • Received December 3, 2008.
      • Accepted February 10, 2009.

    This Article

    1. Published online before print February 24, 2009, doi: 10.2337/dc08-2137
    1. » Abstract
    2. Full Text (PDF)
    3. All Versions of this Article:
      1. dc08-2137v1
      2. 32/6/1098most recent

    Current Issue

    1. December 2009, 32 (12)
    1. Current Issue
    1. Alert me to new issues of Diabetes Care