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Title: Association of High Sensitivity C-reactive Protein with Type II Diabetic Retinopathy
Authors: Shazia Junaid, Lubna Gohar, Hina Moazzam, Sana Ahmad, Sadia Rehman, Khubaib Ahmad
Journal: Journal of Islamabad Medical and Dental College (JIMDC)
Publisher: Healers Educational Society
Country: Pakistan
Year: 2023
Volume: 12
Issue: 4
Language: English
DOI: 10.35787/jimdc.v12i4.1001
Keywords: DiabetesCRPdiabetic retionopathy
Objective: The objective of this study is to find out the association of diabetic retinopathy with serum homocysteine and high sensitivity (hs) CRP levels.
Methods: The research was conducted out at the Army Medical College's Department of Physiology and Centre for Research in Experimental and Applied Medicine (CREAM), Rawalpindi, in partnership with the Armed Forces Institute of Ophthalmology, Rawalpindi for a tenure of 12 months. Ninety subjects, were included in the study, thirty in each group: controls, diabetic subjects, and the patients suffering from diabetic retinopathy (DR).
Results: Healthy controls, diabetic subjects, and patients with DR were found to have mean Fasting Blood Glucose (FBG) values of 5.51 0.34 (mmol/l), 8.11 0.67 (mmol/l), and 8.73 0.90 (mmol/l), respectively (p=0.001). The mean HbA1c level in normal subjects was noted as 5.08 ± 0.27 in healthy controls as compared to 7.70 + 0.89 (mmol/l)) in diabetic subjects and 9.02 + 1.76 (mmol/l) in patients with DR  (p=0.001 by ANOVA). 
          In normal subjects, the mean hs CRP levels were noted to be 3.74 + 1.97 (mg/l) in healthy controls as compared to 15.32 + 2.93 (mg/l) in diabetic subjects and 26.71 + 4.88 (mg/l) in patients with diabetic retinopathy (p=0.001 by ANOVA).
Conclusion: During the study, it was found that elevated levels of these inflammatory biomarkers can accurately predict the onset of diabetic retinopathy and that hs CRP levels are strongly related with the development of diabetic retinopathy. Monitoring these inflammatory signs in the serum can therefore help prevent diabetic microangiopathic consequences, including DR.
To find out the association of diabetic retinopathy with high sensitivity (hs) CRP levels.
A descriptive cross-sectional study conducted at Army Medical College's Department of Physiology and Centre for Research in Experimental and Applied Medicine (CREAM), Rawalpindi, in partnership with the Armed Forces Institute of Ophthalmology (AFIO), Rawalpindi for 12 months. Ninety subjects were included, divided into three groups: controls (n=30), diabetic subjects (n=30), and patients suffering from diabetic retinopathy (DR) (n=30). Blood samples were collected for analysis of Fasting Plasma Glucose (FPG), HbA1c, and hs-CRP levels.
graph TD
A["Recruit Subjects: Controls, Diabetic, DR"] --> B["Collect Blood Samples"];
B --> C["Measure FPG, HbA1c, hs-CRP"];
C --> D["Analyze Data"];
D --> E["Draw Conclusions"];
The study found significantly elevated levels of hs-CRP in diabetic patients, particularly those with diabetic retinopathy, compared to healthy controls. This suggests that hs-CRP is a potential biomarker for predicting the onset and progression of diabetic retinopathy. The positive correlation between hs-CRP, FPG, and HbA1c further supports its role in the inflammatory processes associated with diabetes. While some studies show conflicting results regarding the correlation of hs-CRP with age and BMI in DR, this study highlights the strong association between hs-CRP and glycemic control in the context of diabetic retinopathy.
- Mean FPG values were 5.51±0.34 mmol/l (controls), 8.11±0.67 mmol/l (diabetic), and 8.73±0.90 mmol/l (DR) (p=0.001).
- Mean HbA1c levels were 5.08±0.27% (controls), 7.70±0.89% (diabetic), and 9.02±1.76% (DR) (p=0.001).
- Mean hs-CRP levels were 3.74±1.97 mg/l (controls), 15.32±2.93 mg/l (diabetic), and 26.71±4.88 mg/l (DR) (p=0.001).
- A statistically significant positive correlation was found between hs-CRP and FPG (r=0.802, p<0.0001) and HbA1c (r=0.734, p<0.0001).
- No significant correlation was found between hs-CRP and age (r=0.109, p=0.308) or BMI (r=0.124, p=0.243).
Elevated levels of hs-CRP are strongly correlated with the onset of diabetic retinopathy. Monitoring hs-CRP levels in diabetic patients can aid in the early detection and prevention of diabetic microangiopathic consequences, including diabetic retinopathy.
- The study included 90 subjects, with 30 in each of the three groups (controls, diabetic, diabetic retinopathy).
- Mean hs-CRP levels in healthy controls were 3.74±1.97 mg/l, in diabetic subjects were 15.32±2.93 mg/l, and in DR patients were 26.71±4.88 mg/l.
- A statistically significant p-value of 0.001 was obtained for the differences in FPG, HbA1c, and hs-CRP levels between the three groups.
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