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R.C. Nayak, K. Lynch, C. Gustavsson, P.J. Farthing–Nayak, C.–D. Agardh, E. Agardh; Circulating Anti–Pericyte Autoantibodies: A Novel Modifier of Risk of Progression of Diabetic Retinopathy? . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3872.
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Anti–pericyte autoantibodies (APAA) are present in high frequency among diabetic subjects with and without non–proliferative retinopathy. This study aimed to determine whether progression of retinopathy in type 2 diabetes was associated with the same medical risk factors in APAA positive as in APAA negative subjects.
Type 2 diabetic patients with non–proliferative diabetic retinopathy at baseline were followed prospectively for two years monitoring progression of retinopathy. 38/175 (21.7%) patients showed progression in EDTRS grade by >2 steps in at least one eye. Serum APAAs were detected by immunofluorescence on tissue–cultured bovine retinal pericytes.
Progression of retinopathy was associated with HbA1c (p=0.002), diabetes duration (p=0.03), and albumin creatinine ratio (p=0.02) in APAA negative but not in APAA positive subjects. The association between progression and APAA was strongest in the upper quartile for HbA1c (>8.0%), where 71.4% of patients negative for APAA progressed in retinopathy while only 24.1% of patients positive for APAA progressed (p=0.007).
The results suggest that APAA is a modifier of risk of progression of retinopathy due to hyperglycemia and that it could be useful as a biochemical marker of risk of progression of diabetic retinopathy in type 2 diabetic patients with poor metabolic control.
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