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Potential impact of epicardial fat thickness, pentraxin-3, and high-sensitive C-reactive protein on the risk of non-proliferative diabetic retinopathy

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Abstract

Purpose

We tried to clarify the potential association between systemic inflammatory markers like high-sensitive C-reactive protein (Hs-CRP), pentraxin-3 (PTX3), and epicardial fat thickness (EFT) with the non-proliferative diabetic retinopathy (NPDR) in patients with type 2 diabetes mellitus (T2D). Previous studies dealt with diabetic retinopathy as a whole entity rather than early stages of diabetic retinopathy. Early detection of various determinants of NPDR is prioritized in clinical practice.

Methods

A case–control study was conducted at Mansoura University Hospital, included 207 Egyptian subjects divided into 3 groups; 69 diabetic patients without retinopathy, 69 diabetic patients with NPDR, and 69 healthy control subjects. Participants were subjected to clinical history taking, physical examination, and laboratory assessment of Hs-CRP and plasma PTX3. Transthoracic echocardiography was applied to estimate EFT.

Results

Hs-CRP, PTX3, and EFT were significantly higher in patients with T2D without retinopathy than control cohort (p = 0.033, p < 0.00 and p < 0.00, respectively). Moreover, patients with NPDR showed significantly higher values of Hs-CRP, PTX3, and EFT than diabetic comparators without retinopathy (p = 0.002, p = 0.012, and p < 0.001, respectively). Although, NPDR was positively correlated with Hs-CRP, PTX3, and EFT (p < 0.001), Hs-CRP was not an independent determinant of NPDR meanwhile, EFT (OR = 1.094, 95%CI: 1.036–1.154, P = 0.001) and PTX3 (OR = 16.145, 95%CI: 1.676–155.551, P = 0.016) were.

Conclusion

Plasma pentraxin-3 and epicardial fat thickness showed more significant association with NPDR than high-sensitive C-reactive protein in patients with type 2 diabetes mellitus.

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Data availability

The data set generated and/or analyzed during this research are available from the corresponding author upon a reasonable request.

Abbreviations

DR :

Diabetic retinopathy

NPDR :

Non-proliferative diabetic retinopathy

Hs-CRP :

High-sensitive C-reactive protein

PTX3 :

Pentraxin-3

EFT :

Epicardial fat thickness

T2D :

Type 2 diabetes mellitus

DM :

Diabetes mellitus

TSG-14 :

Tumor necrosis factor stimulated- gene-14

ELISA :

Enzyme-linked immunosorbent assay

FPG :

Fasting plasma glucose

HBA1c :

Glycosylated hemoglobin

VEGF :

Vascular endothelial growth factor

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Acknowledgements

The authors acknowledge the valuable participation of Ahmed El-Sebaie; assistant professor of clinical pathology, Clinical Pathology Department, Faculty of Medicine, Mansoura University.

Funding

No funds, grants, or other support was received. This research was funded by authors only. This research received no specific grants from any funding agency in the public, commercial or not-for-profit sectors.

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Authors and Affiliations

  1. Endocrinology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia, Egypt

    Mohammed Ali Gameil, Hanan Abdelhay Elsherbiny & Ahmed Abd EL-Hakim Arafat

  2. Cardiovascular Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia, Egypt

    Ibrahim Elsayed Youssry

  3. Ophthalmology Department, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia, Egypt

    Sara Abdel Gawad

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  1. Mohammed Ali Gameil
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Contributions

M A G (author 1) contributed at the conception, study design, literature review, analyzed the data and shared in the final manuscript writing. H A E (author 2) was the major contributor of data analysis, statistical analysis and critical revision and editing the final manuscript. I E Y (author 3) shared in the literature review, was the major contributor in cardiology workup, critical revision and analysis of results, and editing of the manuscript draft. S A G (author 4) shared in ophthalmology workup, data collection, analysis, critical revision of the results and final manuscript writing. A A A (author 5) shared in study conception, literature review, data analysis, was the major contributor of writing the final manuscript.

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Correspondence to Mohammed Ali Gameil.

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Ethical approval

This study was approved by the Institutional Review Board for Clinical Research committee of Mansoura University with approval number (R.20.05.835). All procedures were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Gameil, M.A., Elsherbiny, H.A., Youssry, I.E. et al. Potential impact of epicardial fat thickness, pentraxin-3, and high-sensitive C-reactive protein on the risk of non-proliferative diabetic retinopathy. J Diabetes Metab Disord 22, 735–742 (2023). https://doi.org/10.1007/s40200-023-01195-4

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