Aims
This study was undertaken to determine whether levels of inflammation and endothelial dysfunction biomarkers in serum samples collected at baseline in the Diabetes Control and Complications Trial (DCCT) cohort could predict the development of retinopathy.
Methods
Levels of clotting/fibrinolysis, inflammation and endothelial dysfunction biomarkers were measured in 1391 subjects with type 1 diabetes to determine whether their levels predicted increased risk to develop or accelerated progression of retinopathy during 16 years of follow-up.
Results
Using regression models adjusted for DCCT treatment group, duration of diabetes, baseline retinopathy scores, HbA1c and albumin excretion rate, the baseline levels of sE-selectin and PAI-1 (active) were significantly associated with increased risk of a 3-step progression in retinopathy score in the Primary Prevention Cohort (PPC). After adjusting for additional covariates (e.g., ACE/ARB and statin therapy), this association persisted. Levels of active and total PAI-1 in the same group were also significantly associated, after similar adjustments, with the time to progress to severe non-proliferative retinopathy during the follow-up period (54% and 29%, respectively of increased risk). No associations were observed in the Secondary Intervention Cohort for any of the outcomes.
Conclusions
High levels of sE-selectin and PAI-1 are associated with the development of retinopathy in patients with uncomplicated type 1 diabetes.
Brain natriuretic peptide (BNP) is elevated in hemodialysis (HD) patients and predicts increased mortality. Intra- and interdialytic changes in BNP have not been fully described. End-stage renal disease (ESRD) patients were prospectively recruited at three dialysis centers. At five visits, over a 6-week period, pre- and postdialysis BNP levels were measured. Pre- and postdialysis weights, blood pressure, fluid removed/given and demographic/medical information were recorded. Mean pre- and post-HD BNP (log-transformed) was not significantly different and did not correlate with fluid removed. Both pre- and post-HD BNP significantly decreased across the dialysis week (Pre-HD: intercept = 2.69, slope = -0.097, t = -6.7, P < 0.001) and across the five sessions (slope = -0.046, t = -2.47, P = 0.01). Interdialytic BNP changes are not related to fluid removed. Chronic volume overload and increased left ventricular wall tension likely account for the BNP decrease across dialysis weeks and may be related to higher death rates among HD patients at the beginning of the week.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.