RESUMO
Purpose: To evaluate the association between retinal and choroidal thickness and serum and aqueous humor (AH) adiponectin concentrations in patients with diabetic retinopathy (DR). Methods: This prospective study enrolled diabetic patients without DR (group 1, n = 46) and with DR (n = 130). Central foveal thickness (CFT), subfoveal choroidal thickness (SCT), and adiponectin in serum and AH concentrations were compared. For subgroup analysis, the DR group was divided into four subgroups: mild (group 2), moderate (group 3), severe nonproliferative DR (group 4), and panretinal photocoagulation (group 5). Results: The log-transformed serum and AH adiponectin concentrations in patients with DR (groups 2-5) were higher than in patients without DR (all Ps < 0.001). In addition, serum and AH adiponectin concentrations showed a positive linear correlation with DR severity (P < 0.001 and P = 0.001, respectively). In univariate analysis between serum or AH adiponectin concentrations and CFT or SCT, AH adiponectin significantly correlated with CFT and SCT (all Ps < 0.001). However, serum adiponectin concentration significantly correlated with SCT (P = 0.041) but not with CFT (P = 0.337). In multivariate analysis, AH adiponectin concentration significantly correlated with CFT, but serum adiponectin concentration did not (P = 0.002 and 0.309, respectively). In contrast, serum and AH adiponectin concentrations significantly correlated with SCT (P = 0.048 and 0.041, respectively). Conclusions: Serum and AH adiponectin concentrations are positively associated with DR development and progression. Additionally, SCT looks related to the serum and AH adiponectin concentrations, whereas CFT looks related to AH adiponectin concentrations.
Assuntos
Diabetes Mellitus Tipo 2 , Retinopatia Diabética , Humanos , Adiponectina , Estudos Prospectivos , Retina , Tomografia de Coerência Óptica , CorioideRESUMO
PURPOSE: To compare adiponectin (APN) levels in the serum and aqueous humor (AH) and evaluate their association with the development/progression of diabetic retinopathy (DR). METHODS: Diabetic patients with (group 3; n = 59) and without (group 2; n = 39) DR and age- and sex-matched normal subjects (group 1; n = 35) were compared. Duration of diabetes, body mass index, serum HbA1c, vascular endothelial growth factor (VEGF), APN, pentraxin 3 (PTX3), platelet derived growth factor (PDGF), intercellular adhesion molecule-1 (ICAM-1), and APN were measured and analyzed. RESULTS: One hundred and thirty-three participants were included. Compared to patients without diabetes, diabetic patients with DR had significantly elevated average serum APN levels (5.99±3.89 µg/ml versus 3.51±1.44 µg/ml, P = 0.002) and average AH APN levels (10.94±11.74 ng/ml versus 3.65±3.33 ng/ml, P<0.001). Serum APN was significantly correlated with AH APN (R = 0.512, P<0.001) and AH VEGF (R = 0.202, P = 0.020). The log serum APN was significantly correlated with intraocular cytokines, including log APN, log VEGF, log ICAM, log leptin, log PTX3, log PDGF, angiopoietin, C-reactive protein, and interleukins (IL)-5 and IL-10 (P<0.001, P = 0.020, P<0.001, P<0.001, P = 0.001, P<0.001, P = 0.008, P = 0.009, P<0.001, and P = 0.046, respectively). Log serum VEGF showed a significant correlation only with log AH VEGF (P = 0.001). Multivariate logistic analysis was performed to evaluate the association of DR progression and cytokine concentrations; log Serum APN and log AH APN showed good correlation with the DR progression in each model. CONCLUSIONS: AH APN levels correlated well with DR development and progression. Serum APN could be a better marker for estimating intraocular cytokines, including both intraocular APN and VEGF concentrations in clinical field, than serum VEGF in DR patients.