Prospective study of inflammatory biomarkers and risk of diabetic retinopathy in the diabetes control and complications trial.
Prospective study of inflammatory biomarkers and risk of diabetic retinopathy in the diabetes control and complications trial.
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DOI：
10.1001/jamaophthalmol.2013.2299
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发表时间：
2013-04
影响因子：
8.1
通讯作者：
Schaumberg, Debra A.
中科院分区：
文献类型：
--
作者：
Muni, Rajeev H.;Kohly, Radha P.;Lee, Eudocia Q.;Manson, JoAnn E.;Semba, Richard D.;Schaumberg, Debra A.
旨在确定糖尿病控制和并发症试验 (DCCT) 队列中 hsCRP 和 ICAM-1 的基线水平是否可以预测糖尿病视网膜病变 (DR)、临床显着黄斑水肿 (CSME)、视网膜硬渗出物和增殖性 DR 的发生和进展。 DCCT 是一项大型多中心随机对照临床试验，纳入了 1441 名 1 型糖尿病受试者，研究开始时年龄为 13-39 岁。我们测量了储存的基线血液样本中的 hsCRP、ICAM-1、VCAM-1 和 TNFR1 水平，并评估了它们与事件 DR 终点的关联，这些终点是通过基线和随访期间每 6 个月拍摄的标准化七视野立体视网膜彩色照片的分级确定的。调整随机治疗分配和其他因素后，我们观察到 hsCRP 与 CSME 风险之间存在统计学上显着的关联，最高与最低五分位数的风险比 (HR) 为 1.83 (95%CI=0.94–3.55)，趋势 P=0.01。同样，对于视网膜硬渗出物的形成，hsCRP 顶部五分位数与底部五分位数的 HR 为 1.78 (95%CI=0.98–3.25)，趋势 P=0.004；而对于 ICAM-1，比较顶部与底部五分位数的 HR 为 1.50 (95%CI=0.84–2.68)，趋势 P=0.05。基线 VCAM-1 或 TNFR1 与任何 DR 终点的风险之间没有统计学上的显着关联。在调整已知的风险因素后，基线 hsCRP 五分位数的增加预示着 DCCT 队列中发生 CSME 和黄斑硬渗出事件的风险更高。 ICAM-1 的循环水平也可能与视网膜硬渗出物的形成有关。
To determine whether baseline levels of hsCRP and ICAM-1 predict development and progression of diabetic retinopathy (DR), clinically significant macular edema (CSME), retinal hard exudates, and proliferative DR in the Diabetes Control and Complications Trial (DCCT) cohort. The DCCT was a large multicenter randomized controlled clinical trial of 1441 subjects with type 1 diabetes aged 13–39 years at study entry. We measured levels of hsCRP, ICAM-1, VCAM-1, and TNFR1 in stored baseline blood samples and assessed their association with incident DR endpoints ascertained from grading of standardized seven-field stereoscopic retinal color photographs taken at baseline and every 6 months during follow-up. After adjustment for randomized treatment assignment and other factors, we observed a statistically significant association between hsCRP and risk of CSME, with a hazard ratio (HR) for the top versus bottom quintile of 1.83 (95%CI=0.94–3.55), P for trend=0.01. Similarly, for the development of retinal hard exudates, the HR for the top versus bottom quintile of hsCRP was 1.78 (95%CI=0.98–3.25), P for trend=0.004; whereas for ICAM-1, the HR comparing the top versus bottom quintiles was 1.50 (95%CI=0.84–2.68), P for trend=0.05. There were no statistically significant associations between baseline VCAM-1 or TNFR1 and risk of any of the DR endpoints. After adjusting for known risk factors, increasing quintiles of baseline hsCRP predicted higher risks of incident CSME and macular hard exudate in the DCCT cohort. Circulating levels of ICAM-1 may also be associated with the development of retinal hard exudates.
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影响因子：
4.2
作者：
Gardner, Thomas W.;Antonetti, David A.
通讯作者：
Antonetti, David A.
影响因子：
3.5
作者：
Spijkerman, A. M. W.;Gall, M.-A.;Stehouwer, C. D. A.
通讯作者：
Stehouwer, C. D. A.
影响因子：
4.6
作者：
Nowak, Mariusz;Wielkoszynski, Tomasz;Nowak, Katarzyna
通讯作者：
Nowak, Katarzyna
影响因子：
7.7
作者：
Miljanovic, B;Glynn, RJ;Schaumberg, DA
通讯作者：
Schaumberg, DA
影响因子：
8.2
作者：
van Hecke, MV;Dekker, JM;Stehouwer, CDA
通讯作者：
Stehouwer, CDA