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M.P. Karavellas, E. Papadoyiannis, G. Georgas, C. Tsatsanis, M. Tsilimbaris, D. Skondras, A. Marioris, I. Pallikaris, S. Papavasiliou; Association of TNF-alpha Serum Levels with Status of Diabetic Retinopathy and Other Clinical Complications of Diabetes . Invest. Ophthalmol. Vis. Sci. 2003;44(13):3984.
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Purpose: To investigate the relationship between circulating levels of TNF-alpha and the status of diabetic retinopathy, glycemic control, macrovasculopathy and neuropathy in diabetic patients.Methods:Serum levels of TNF-alpha and HbA1c were measured in 51 patients with diabetic retinopathy, 13 diabetic patients without retinopathy, and in a control group of 16 non-diabetic patients.Diabetic retinopathy was assessed by fundoscopy and fluorescein angiography. Macrovasculopathy and neuropathy were assessed clinically and with laboratory investigations. Results:Patients with diabetes had significantly higher levels of circulating TNF-alpha compared with non-diabetic patients (p=0.01). Among diabetic patients the presence of diabetic retinopathy was associated with statistically significantly higher levels of TNF-alpha (p=0.009), while the presence of CSME and a history of PRP did not significantly affect TNF-alpha levels (p=0.43,p=0.07 respectively).Systemic hypertension(p=0.27), macrovasculopathy(p=0.39)and neuropathy(p=0.09)were not associated with higher TNF-alpha levels. Status of glycemic control (HbA1c>7.5, p=0.44)did not affect TNF-alpha levels among diabetic patients. Independent of diabetes status patients older than 65 years of age tended to have higher levels of TNF-alpha compared with younger patients (p=0.019).Conclusion: Diabetic retinopathy is associated with increased levels of TNF-alpha in diabetic patients. Other clinical complications of diabetes do not show a similar association.TNF-alpha may play a role in the pathogenesis of diabetic retinopathy..
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