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S. Woo, S. Ahn, K. Lee, K. Park; Association of Systemic Neutrophil Count With Diabetic Retinopathy: Evidence of Neutrophil-Mediated Inflammation on the Development of Microvascular Complications of Diabetes Mellitus. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5057.
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To evaluate the association between systemic neutrophil count and the presence and severity of diabetic retinopathy (DR).
40440 people who visited Seoul National University Bundang Hospital for medical checkup between July 2004 and June 2008 were included in this study. Among them, 2502 diabetic patients were classified into non-DR or DR group according to ETDRS classification of DR.The intensive laboratory tests including systemic inflammatory markers such as absolute neutrophil count (ANC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) and full medical records of subjects were obtained. ANCs were compared between patients with and without DR and the correlation between ANC and the severity of DR was evaluated. ANC before and after the onset or progression of DR were also analyzed. To investigate the association of ANC with diabetic nephropathy, correlations between ANC and renal function indicators (serum creatinine and urine microalbuminuria) were evaluated.
The level of ANC was significantly higher in DR group than non-DR group and in diabetic patients than non-diabetic subjects, while other inflammatory markers showed no difference. The level of ANC demonstrated a graded response with the severity of DR even after adjusting other clinical factors. In the serial follow-up of part of subjects in DR group, ANC showed increasing trend along with progression of DR. In addition, ANC showed correlation with serum creatinine and urine microalbuminuria.
Systemic neutrophil count is associated with the presence and severity of DR. Neutrophil-mediated inflammation may play a role in the development and progression of DR, and more generally, diabetic microvascular complications.
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