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Mediators of Inflammation
Volume 2013, Article ID 818671, 10 pages
http://dx.doi.org/10.1155/2013/818671
Clinical Study

Inflammation, Haemostatic Disturbance, and Obesity: Possible Link to Pathogenesis of Diabetic Retinopathy in Type 2 Diabetes

1Department of Ophthalmology, University Clinic Vuk Vrhovac, Clinical Hospital Merkur, Zajčeva 19, 10000 Zagreb, Croatia
2Department of Endocrinology and Metabolic Diseases, University Clinic Vuk Vrhovac, Clinical Hospital Merkur, Zajčeva 19, 10000 Zagreb, Croatia
3Department of Ophthalmology, Clinical Hospital Dubrava, Avenija Gojka Šuška 6, 10000 Zagreb, Croatia
4Department of Ophthalmology, General Hospital Dubrovnik, Dr. Roka Mišetića 2, 20000 Dubrovnik, Croatia
5Faculty of Forestry, University of Zagreb, Svetošimunska 25 p.p. 422, 10002 Zagreb, Croatia
6Croatian National Institute of Public Health, Rockefellerova 7, 10000 Zagreb, Croatia

Received 16 August 2013; Revised 20 October 2013; Accepted 21 October 2013

Academic Editor: Katarzyna Zorena

Copyright © 2013 Martina Tomić et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. The pathogenesis of diabetic retinopathy (DR) is insufficiently understood but may possibly involve chronic, low-grade inflammation. The aim of this cross-sectional study was to investigate the relationship between inflammatory and haemostatic markers, other markers of endothelial dysfunction and anthropometric parameters, and their association with DR in patients with type 2 diabetes. Methods. According to the DR status patients were divided into three groups: no retinopathy, mild/moderate nonproliferative (NPDR), and severe NPDR/proliferative retinopathy (PDR). Results. The groups did not differ in the levels of inflammatory and haemostatic markers, other markers of endothelial dysfunction, and anthropometric parameters. After dividing the patients according to the level of obesity (defined by BMI, WC, and WHR) into three groups ANOVA showed the differences in C-reactive protein according to the WC ( ) and in fibrinogen according to the WHR ( ) as well as in total cholesterol ( ) and triglycerides ( ) according to the BMI. Logistic regression analyses showed that diabetes duration and prolonged poor glycemic control are the main predictors of retinopathy in patients with type 2 diabetes. Conclusion. Interrelations between obesity, inflammation, haemostatic disturbance, and other risk factors may possibly play an important additional role in endothelial dysfunction involved in the pathogenesis of diabetic retinopathy.