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Shigehiko Kitano, Kensuke Haruyama; The Relationship Between Serum Levels of VEGF, IGF-1, Angiotensin II, ICAM-1 and The Progression of Diabetic Retinopathy During Glycemic Control. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2876.
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To examine the relationship between the serum levels of cytokines or adhesion molecules and progression of diabetic retinopathy in non-proliferative diabetic retinopathy (NPDR) with poor glycemic control.
We prospectively evaluated 29 eyes of 29 patients of diabetes mellitus with NPDR, having HbA1c values of 10% or more at baseline. Serum levels of Vascular endothelial growth factor (VEGF), insulin-like growth factor-1 (IGF-1) and intercellular adhesion molecule-1 (ICAM-1) were measured by ELISA, angiotensin II (AII) by RIA, and HbA1c values were measured at baseline and at 1, 3, 6 and 12 months. Classification of retinopathy was performed based on fundus photographs using the modified Early Treatment of Diabetic Retinopathy Study Classification in retinopathy (modified ETDRS). Patients were classified into 2 groups: rapid improvement in blood glucose level, having a decrease in HbA1c value of more than 3.0% within 3 months (rapid group); and gradual improvement in blood glucose level, having a decrease in HbA1c value of less than 3.0% within 3 months(gradual group).
A comparison between the rapid group (n = 19) and the gradual group (n = 11) showed no statistically significant differences in VEGF, IGF-1, ICAM-1 and AII. In the rapid group, the serum levels of IGF-1 at 1, 3, 6 and 12 months were statistically higher at baseline (p = 0.038, 0.043, 0.002, 0.042). In the rapid group the serum levels of IGF-1 were statistically significantly higher in the progressive group (having progression of two steps or more on modified ETDRS) than in the non-progressive group at 1, 3 and 6 months (p = 0.046, 0.046, 0.016).
Based on these results, IGF-1 may be a risk factor for progressive retinopathy in rapid glycemic control.
Clinical Trial: :
Tokyo Women's Medical University, 775
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