الفهرس 
Diabetes MellitusOnly 14 pages are availabe for public view
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Abstract
D
iabetic retinopathy (DR) is a chronic progressive, potentially sight-threatening disease of the retinal microvasculature associated with the prolonged hyperglycemia and other conditions linked to diabetes mellitus such as hypertension. Legal blindness due to DR is estimated to be 25 times more common among the diabetic population than in those without diabetes.
Pentraxin 3 (PTX3) is an acute-phase reactant characterized by a cyclic multimeric structure. Pentraxin 3, in the form of a long pentraxin, is produced by peripheral tissues and reflects impaired vascular endothelial function.
The aim of the present study was to assess the relationship between serum Pentraxin 3 (PTX3) in type 2 Diabetes and retinopathy.
This study was conducted on 70 patients with type 2 DM and 20 healthy subjects as a control with their ages ranging from 40-70. They were collected from outpatient diabetes and endocrinology clinic at El Demerdash Hospital, Ain-Shams University and outpatient diabetes and endocrinology clinic at National Institute of Diabetes and Endocrinology; it was conducted from January to July, 2019. The study was explained to all patients and written consent was obtained from them before starting the study.
The selected subjects were divided into 3 main groups:
group I: includes 50 patients with type 2 DM complicated with diabetic retinopathy, this group was further subdivided to:
Subgroup Ia: Diabetic patients with Proliferative diabetic retinopathy (PDR).
Subgroup Ib: Diabetic patients with Non-Proliferative diabetic retinopathy (NPDR).
group II: includes 20 patients with type 2 DM without retinopathy.
group III: includes 20 apparently healthy subjects representing control group.
All subjects were submitted to the following:
Full history:
• Personal history: including age and sex.
• History of diabetes:
Duration of diabetes.
Diabetes Treatment.
• Family history of diabetes mellitus.
• Smoking.
Clinical examination including the following item:
• Assessment of BMI (kg/m2).
• Assessment of blood pressure.
Fundus examination:
• Fundus examination by ophthalmologist through a dilated pupil by indirect ophthalmoscope. NPDR was diagnosed by the presence of cotton wool spots, microanuresms and boat shaped hemorrhages and PDR was diagnosed by the presence of neovascularization in the retina.
Laboratory tests includes:
• Fasting and 2h postprandial blood glucose (mg/dl)
• HbA1c (%)
• Serum creatinine and urea.
• ALT, AST and serum albumin.
• Microalbuminuria.
• Serum pentraxin3.
We found that:
Plasma PTX3 level was significantly higher in diabetic patients with diabetic retinopathy than that in both diabetic patients without diabetic retinopathy and control healthy subjects (3.20 ± 0.035 ng/dl versus 2.88 ± 0.32 ng/dl and 2.88 ± 0.167 ng/dl respectively; P-value =0.000).
The Correlation between pentraxin 3 and other measured parameters in all studied subjects showed a statistical positive correlation between log PTX3 and age, duration of diabetes, DBP, FBG, 2HPP, HBA1c, albumin, creatinine, urea, microalbuminuria.
CONCLUSION
Serum pentraxin 3 is strongly correlated to diabetic retinopathy, the higher the grade of retinopathy, the higher the pentraxin 3 level. So, could be pentraxin 3 a reliable predictor for diabetic retinopathy.
Serum pentraxin 3 and diabetic retinopathy are strongly correlated to level of glycaemia and duration of diabetes. Drawing the attention to the role of tight glycemic control in the prevention or slowing diabetic retinopathy progression.
Serum pentraxin 3 and diabetic retinopathy are strongly correlated to micro-albuminuria. Drawing the attention to the relation between diabetic retinopathy and nephropathy.
RECOMMENDATIONS
• Larger studies using more defined populations are required to better understand the relationship between PTX 3 concentrations and retinopathy in patients with diabetes mellitus.
• Further studies to detect the role of serum pentraxin 3 in other micro-vascular and macro-vascular diabetic complications.
• Early referral for patients with diabetic retinopathy to experienced ophthalmologists is required.
• Good glycemic control is crucial to control the progression of diabetic retinopathy.