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Olga G. Shilova, Sergei A. Zhuikov, Svetlana V. Philippova, Gennady P. Philippov, Yuri I. Tyukalov, Natalia P. Kovaleva; Correlations between Parameters of Blood and Intraocular Fluid (IOF) Homeostasis and Stage of Diabetic Retinopathy (DR) in Patients with Type II Diabetes Mellitus (DM). Invest. Ophthalmol. Vis. Sci. 2012;53(14):2856.
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© ARVO (1962-2015); The Authors (2016-present)
To assess parameters of osmotic homeostasis of blood serum and IOF in patients with type II DM.
Study included 243 patients with type II DM, aged 45-75 years. All patients had undergone anterior or posterior segment eye surgery. During the surgery, 0.2ml of IOF and 5-10ml of venous blood were collected from each patient. Concentrations of glucose, calcium, sodium, potassium, and urea, were measured for blood serum and IOF, using standard sets of reagents (Liquick Cor-GLUCOSE 30, 120, 500, Cormay, UK; SODIUM "E-D", Vital Diagnostics SPb, Russia; FLUITEST® Ca-CPC, Biogon® Diagnostik, Germany; UREA "E-D", Vital Diagnostics SPb, Russia). Same measurements were taken from 32 patients with type II DM without DR, as control data for further comparisons.
Patients with DR-1 (n=67) showed high positive correlation between blood and IOF glucose concentrations (r=0.54; p=0.037), and mild positive correlations between blood and IOF concentrations of urea (r=0.20; p=0.049), calcium (r=0.24; p=0.045), and sodium (r=0.23; p=0.044). In DR-2 (n=92), a decrease of correlation between blood and IOF glucose concentrations (r=0.29; p=0.031) and change of direction of correlation for sodium concentrations (r=-0.21; p=0.043) were observed. Whereas correlation for calcium remained the same as in DR II (r=0.25; p=0.040). Mild negative correlation between blood and IOF potassium concentrations (r=-0.22; p=0.046) was observed in patients with preproliferative DR (n=92). DR-3 (n=84) was associated with change of direction for the correlation between blood and IOF glucose levels (r=-0.32; p=0.015) and disappearance of the correlation between blood and IOF concentrations of urea (r=0.18; p=0.12), while correlations for calcium and potassium remained unchanged (r=0.24; p=0.042 and r=-0.23; p=0.045, respectively). Negative correlation between the blood and IOF sodium concentrations has increased (r=-0.30; p=0.040).
Our results help to better understand the underlying mechanisms of progressing DR. As the DR advances, change in correlations between blood levels and IOF levels of glucose, as well as of urea, could result from the activation of protein synthesis associated with proliferative retinopathy.
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