Diabetic retinopathy is the most severe ocular complication of diabetes mellitus (DM), is associated with micro-vascular damage. The more advanced stage, proliferative diabetic retinopathy, has been linked to an increased risk of cardiovascular morbidity and mortality. Our hypothesis was that inflammatory and angiogenic markers will detect the different stages of type 2 diabetes, and may predict development of micro-vascular damage. Methods. Seventy three type II diabetic patients were randomly assigned to three groups (A - 25 patients {12 males], no diabetic retinopathy; B - 25 patients {19 males], non-proliferative retinopathy; and C - 23 patients {13 males], proliferative retinopathy),when they came for a routine follow-up visit in the ophthalmologic outpatient clinic. Twenty-three healthy subjects (14 males) served as controls. High-sensitivity C reactive protein (hs-CRP), soluble vascular cell adhesion molecule 1(sVCAM-1) and vascular endothelial growth factor (VEGF) were studied. Results. The duration of type II diabetes differed between group A (9 ± 6 years) and B (17 ± 9 years) patients (p = 0.001). No such difference was revealed between groups B and C (19 ± 6 years) (p = 0.30). A difference in hemoglobin A1C (HBgA1C) levels was detected between groups A (7.1 ± 2.7%) and B (8.5 ± 1.5%) (p = 0.02), but none was found between groups B and C (8.5 ± 1.6%) (p = 0.98). Only six patients (out of 23) used insulin treatment in group A, compared with 16 in group B (out of 25) and 17 in group C (out of 25) (p = 0.004). All three groups of diabetic patients were older (62.8 ± 10.8, 61.9 ± 9.4, 59.2 ± 10.3 years, respectively) than the controls(44.3 ± 11.6 years) (p≤0.001). Hs-CRP levels were higher in diabetic patients (4,391 ± 4,175, 4,109 ± 4,533, 3,005 ± 3,842 ng/mL, respectively) than in controls (1,659 ± 1,866 ng/mL); however, only the levels in patients of groups A (p = 0.01) and B (p = 0.03) were significantly different from those of the controls, in contrast to group C, which did not differ (p = 0.180). Similar findings were observed for sVCAM-1 (706 ± 347, 746 ± 328, 638 ± 208 ng/mL, respectively, vs. controls {552 ± 143 ng/mL]); sVCAM-1 levels of groups A and B, but not C, differed from the controls (p = 0.05, p = 0.01 and p = 0.125, respectively). With the exception of group B (p = 0.03), soluble VEGF DM type II levels (493 ± 353, 625 ± 342, 368 ± 223 pg/mL, respectively) did not vary from those of the controls (392 ± 355 pg/mL, p≥0.05). However, as the disease progressed, there was a significant decrease in VEGF levels, accompanied by a significant difference between groups B and C (p = 0.006). Conclusions. Patients with diabetes type 2with no-retinopathy and with non-proliferative retinopathy had high levels of inflammatory and angiogenic markers, which decreased in patients with diabetic proliferative retinopathy. Biomarkers of inflammation and angiogenesis may detect the progression of diabetic vascular disease and may lead towards earlier interventions that would prevent systemic complications.

中文翻译：

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VEGF和炎性标志物的减少与糖尿病性增生性视网膜病有关。

糖尿病性视网膜病是糖尿病（DM）最严重的眼部并发症，与微血管损伤有关。晚期糖尿病，增生性视网膜病变，与心血管疾病发病率和死亡率的增加有关。我们的假设是炎症和血管生成标记物将检测2型糖尿病的不同阶段，并可能预测微血管损伤的发展。方法。73名II型糖尿病患者被随机分为三组（A-25例（12例男性），无糖尿病性视网膜病变； B-25例（19例男性），非增生性视网膜病变； C-23例（13例男性， （增生性视网膜病变），当他们来眼科门诊进行例行随访时。23名健康受试者（14名男性）作为对照。研究了高敏C反应蛋白（hs-CRP），可溶性血管细胞粘附分子1（sVCAM-1）和血管内皮生长因子（VEGF）。结果。II型糖尿病的持续时间在A组（9±6岁）和B组（17±9岁）之间有所不同（p = 0.001）。B组和C组（19±6年）之间没有发现这种差异（p = 0.30）。在A组（7.1±2.7％）和B组（8.5±1.5％）（p = 0.02）之间检测到血红蛋白A1C（HBgA1C）水平存在差异，但在B组和C组之间（8.5±1.6％）没有发现差异（ p = 0.98）。A组中只有6名患者（23名患者）使用了胰岛素治疗，而B组中16名（25名患者）和C组17名（25名患者）接受了胰岛素治疗（p = 0.004）。三组糖尿病患者均比对照组（44.3±11.6岁）大（分别为62.8±10.8、61.9±9.4、59.2±10.3年）（p≤0.001）。糖尿病患者的Hs-CRP水平（分别为4,391±4,175、4,109±4,533、3,005±3,842 ng / mL）高于对照组（1,659±1,866 ng / mL）；然而，与C组相比，只有A组（p = 0.01）和B组（p = 0.03）患者的水平与对照组有显着差异（p = 0.180）。sVCAM-1的观察结果相似（分别为706±347、746±328、638±208 ng / mL，而对照组为[552±143 ng / mL]）。A组和B组（而非C组）的sVCAM-1水平与对照组不同（分别为p = 0.05，p = 0.01和p = 0.125）。除了B组（p = 0.03），可溶性II型VEGF DM II水平（分别为493±353、625±342、368±223 pg / mL）与对照组（392±355 pg / mL）没有差异。 mL，p≥0.05）。但是，随着疾病的发展，B组和C组之间的VEGF水平显着降低（p = 0.006）。结论。2型无视网膜病变和非增生性视网膜病变的糖尿病患者的炎症和血管生成标记物水平较高，而糖尿病增生性视网膜病变的患者则有所下降。炎症和血管生成的生物标志物可能会检测出糖尿病性血管疾病的进展，并可能导致可以预防系统性并发症的早期干预措施。