Abstract
Abstract: :
Purpose:To evaluate the role of maternal cytokine levels in retinopathy progression during diabetic pregnancy we investigated the levels of systemic proinflammatory markers C–reactive peptide (CRP), interleukin–6 (IL–6) and circulating vascular cell adhesion molecule–1 (VCAM–1) during pregnancy and postpartum in relation to the development of diabetic retinopathy. Methods: A prospective follow–up study of 63 pregnant women with Type 1 diabetes and 11 nondiabetic pregnant women was performed. Diabetic retinopathy was graded from colour fundus photographs. Plasma levels of systemic CRP and IL–6 and VCAM–1 were measured by immunofluorometric assay (CRP) and by enzyme–linked immunosorbent assay (IL–6 and VCAM–1) in each trimester of pregnancy and 3 and 6 months postpartum. Results: The levels of IL–6, VCAM–1 and CRP did not differ between diabetic and nondiabetic women throughout pregnancy and postpartum. An association between CRP and severity of retinopathy was observed in diabetic women (p=0.021). Additional evidence of interrelationship could be revealed as CRP was higher in those diabetic women with worse glycemic control (HbA1c) (p=0.021). Conclusions:Levels of proinflammatory factors (IL–6, CRP, VCAM–1) seem to be generally similar in Type I diabetic women during pregnancy and postpartum compared to nondiabetic controls. CRP levels were higher in those diabetic women with more severe retinopathy. The tendency for progression of diabetic retinopathy during pregnancy seems not to be mediated by proinflammatory factors.
Keywords: diabetic retinopathy • inflammation • clinical (human) or epidemiologic studies: risk factor assessment