EVALUATION OF ENDOTHELIN-1 AND GLYCATED HAEMOGLOBIN IN TYPE 2 DIABETIC PATIENTS WITH AND WITHOUT RETINOPATHY
Article Sidebar
Main Article Content
Abstract
Introduction: Diabetic retinopathy (DR) can lead to blindness and therefore requires early diagnosis and careful monitoring.
Method: The present cross-sectional analytical survey assessed endothelin-1 (ET-1) and glycated haemoglobin (HbA1C) levels, two DR markers, in type 2 diabetic patients with and without DR in the National Obesity Centre of the Yaoundé Central Hospital in Cameroon, from February 1 to July 31, 2021. It was carried out on DR and non-DR patients, and non-diabetic patients. Various clinical parameters related to diabetes were collected, and a comprehensive ophthalmological examination as well as an analysis of HbA1C and ET-1 in participants’ blood samples were performed.
Results: A total of 12 DR participants, 32 non-diabetic participants, and 45 diabetic participants without DR were enrolled. The majority of diabetic patients did not have a good HbA1C level, without a statistical difference (p-value = 0.702) between DR (75%) and non-DR (80%) patients. For ET-1, it was recorded high serum levels in diabetic patients (10.9 pg/mL [10.00 – 19.50]) compared (p-value = 0.04) to non-diabetic patients (10.6 pg/mL [6.3 – 13.5]). Moreover, DR patients recorded serum levels of ET-1 greater than (p=0.03) non-DR patients (13.1 pg/mL [10.89-21.42] vs 10.8 pg/mL [10.00-18.9]).
Conclusion: These biomarker levels are a warning in DR evolution of diabetic patients. ET-1 could be a better control biomarker than HbA1c in the clinician management of DR according to this study. Thus, it is necessary to improve the description of these biomarkers in order to reinforce their use.
Keywords
Keywords: diabetes, diabetic retinopathy, endothelin-1, glycated haemoglobin.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
References
2. Kang HM, Hasanuzzaman M, Kim SW, Koh HJ, Lee SC. Elevated aqueous endothelin-1 concentrations in advanced diabetic retinopathy. PLOS ONE. 2022; 17: e0268353. https://doi.org/10.1371/journal.pone.0268353
3. Jenkins AJ, Joglekar MV, Hardikar AA, Keech AC, O’Neal DN, Januszewski AS. Biomarkers in Diabetic Retinopathy. Rev. Diabet. Stud. RDS. 2015; 12:159–195. https://doi.org/10.1900/RDS.2015.12.159
4. Lam HC. Lee JK, Lu CC, Chu CH, Chuang MJ, Wang MC. Role of endothelin in diabetic retinopathy. Curr. Vasc. Pharmacol. 2003;1:243–250. https://doi.org/10.2174/1570161033476600
5. Klein R, Be K, Se M, Md D, Dl D. Glycosylated hemoglobin predicts the incidence and progression of diabetic retinopathy. JAMA.1988; 260.
6. Liu QZ, Pettitt DJ, Hanson RL, Charles MA, Klein R, Bennett PH, et al. Glycated haemoglobin, plasma glucose and diabetic retinopathy: cross-sectional and prospective analyses. Diabetologia.1993; 36: 428–432. https://doi.org/10.1007/BF00402279
7. Shiferaw WS, Akalu TY, Desta M, Kassie AM, Petrucka PM, Assefa HK et al. Glycated hemoglobin A1C level and the risk of diabetic retinopathy in Africa: A systematic review and meta-analysis. Diabetes Metab. Syndr. 2020;14: 1941–1949. https://doi.org/10.1016/j.dsx.2020.10.003
8. Maisonpierre PC, Suri C, Jones PF, Bartunkova S, Wiegand SJ, Radziejewski C, et al. Angiopoietin-2, a Natural Antagonist for Tie2 that Disrupts In vivo Angiogenesis. Science, 1997;277(5322):55–60. https://doi.org/10.1126/science.277.5322.55
9. Khanam PA, Hoque S, Begum T, Habib SH, Latif ZA. Microvascular complications and their associated risk factors in type 2 diabetes mellitus. Diabetes Metab. Syndr. 2017; 11 Suppl 2:S577–S581. https://doi.org/10.1016/j.dsx.2017.04.007
10. Selvin E, Ning Y, Steffes MW, Bash LD, Klein R, Wong TY, et al. Glycated Hemoglobin and the Risk of Kidney Disease and Retinopathy in Adults With and Without Diabetes. Diabetes. 2011;60:298–305. https://doi.org/10.2337/db10-1198
11. Bella AL, Koki G, Djouma NF, Aboubakar H, Nomo A, Noa G, et al. Assessment of Systems and Services for Management of Diabetes and Diabetic Retinopathy in Cameroon. Ophthalmic Epidemiology. 2021;28(2):114-121. https://doi.org/10.1080/09286586.2020.1799414
12. Sorrentino FS, Matteini S, Bonifazzi C, Sebastiani A, Parmeggiani F. Diabetic retinopathy and endothelin system: microangiopathy versus endothelial dysfunction. Eye Lond. Engl. 2018;32:1157–1163. https://doi.org/10.1038/s41433-018-0032-4
13. Tarr JM, Kaul K, Chopra M, Kohner EM, Chibber R. Pathophysiology of diabetic retinopathy. ISRN Ophthalmol. 2013; 343560. https://doi.org/10.1155/2013/343560
14. Ferri C, Pittoni V, Piccoli A, Laurenti O, Cassone MR, Bellini C, et al. Insulin stimulates endothelin-1 secretion from human endothelial cells and modulates its circulating levels in vivo. J. Clin. Endocrinol. Metab. 1995;80: 829–835. https://doi.org/10.1210/jcem.80.3.7883838
15. Ergul A. Endothelin-1 and Diabetic Complications: Focus on the Vasculature. Pharmacol. Res. 2011;63: 477–482. https://doi.org/10.1016/j.phrs.2011.01.012
16. Sagar SKD, Zhang C, Guo Q, Yi R, Lin-Tang. Role of expression of endothelin-1 and angiotensin-II and hypoxia-inducible factor-1α in the kidney tissues of patients with diabetic nephropathy. Saudi J. Kidney Dis. Transplant. Off. Publ. Saudi Cent. Organ Transplant. Saudi Arab. 2013;24:959–964. https://doi.org/10.4103/1319-2442.118098
17. Schneider JG, Tilly N, Hierl T, Sommer U, Hamann A, Dugi K, Leidig-Bruckner G, KasperkvC. Elevated plasma endothelin-1 levels in diabetes mellitus. Am. J. Hypertens. 2002; 15:967–972. https://doi.org/10.1016/s0895-7061(02)03060-1
18. Tangjai P, Chingchana P, Taweerutchana R. Glycated Haemoglobin and Diabetic Retinopathy in Type 2 Diabetic Patients in HRH Princess Maha Chakri Sirindhorn Medical Center. J. Med. Assoc. Thail. Chotmaihet Thangphaet. 2015;98 Suppl 10:S135-142.