Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
The Effect of Systemic Inflammatory Biomarkers and Dyslipidemia on the Prognosis of Diabetic Retinopathy in Patients with Type 2 Diabetes Mellitus: Retrospective Research
Tip 2 Diabetes Mellituslu Hastalarda Sistemik İnflamatuar Biyobelirteçlerin ve Dislipideminin Diyabetik Retinopati Şiddetine Etkisi: Retrospektif Araştırma
Levent DOĞANa , Ömer ÖZERa , Emin GÜÇLÜb
aNiğde Ömer Halisdemir University Faculty of Medicine, Department of Ophthalmology, Niğde, Türkiye
bMersin City Hospital, Clinic of Ophthalmology, Mersin, Türkiye
Turkiye Klinikleri J Ophthalmol. 2024;33(4):219-28
doi: 10.5336/ophthal.2024-103341
Article Language: EN
Full Text
ABSTRACT
 Objective: To evaluate the levels of serum lipid and inflammatory biomarkers in patients with Type 2 diabetes mellitus (T2DM) and to determine the effects of these biomarkers on the presence and severity of diabetic retinopathy (DR). Material and Methods: This retrospective study included 544 patients with T2DM divided into three groups: those without diabetic retinopathy, those with non-proliferative diabetic retinopathy (NPDR), and those with proliferative diabetic retinopathy (PDR). A control group of 154 healthy individuals was also included. The study examined inflammatory indices and lipid parameters in these patients. The changes in parameters in the presence of diabetes and how they vary according to the severity of DR were also investigated. Results: The T2DM group consisted of 291 females (53.5%) and 253 males (46.5%), while the control group comprised 81 females (52.5%) and 73 males (47.5%). T2DM patients exhibited significantly higher triglycerides and total cholesterol (p<0.001), with further significant elevations observed in patients with NPDR and PDR compared to the NPDR group (p<0.001). C-reactive protein, systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), were all significantly elevated in the T2DM group (p<0.05). Notably, PDR patients displayed significantly higher SII, SIRI, NLR, and PLR values compared to both patients with NPDR and those without DR (p<0.05). Conclusion: Inflammation and dyslipidemia may play an important role in the development, course, and treatment of DR. Consideration of these factors during follow-up and treatment may improve clinical care. Prospective studies involving large populations are needed to better observe all these effects and to increase their reliability.

Keywords: Diabetic retinopathy; risk factors; inflammation biomarkers; triglyceride; cholesterol
ÖZET
 Amaç: Bu çalışmanın amacı, Tip 2 diabetes mellituslu (T2DM) hastalarda serum lipid ve inflamatuar biyobelirteçlerin düzeylerini incelemek ve bu biyobelirteçlerin diyabetik retinopati (DR) varlığı ve şiddeti üzerindeki etkilerini belirlemektir. Gereç ve Yöntemler: Bu retrospektif çalışmaya 544 T2DM hastası ve 154 sağlıklı kontrol grubu dâhil edildi. T2DM hastaları kendi içerisinde diyabetik retinopatisi olmayan, non-proliferatif diyabetik retinopatisi (NPDR) olanlar ve proliferatif diyabetik retinopatisi [proliferative diabetic retinopathy (PDR)] olanlar olarak 3 ayrı gruba ayrıldılar. Bu katılımcılarda kan hücreleri ilintili inflamasyon belirteçleri ve serum lipid düzeyleri incelendi. Bu parametrelerin ayrıca diyabet varlığında ve DR şiddetindeki artışla gerçekleşen değişimleri incelendi. Bulgular: T2DM'li hastaların 291'i (%53,5) kadın 253'ü (%46,5) erkek iken, kontrol grubunda 81 (%52,5) kadın ve 73 (%47,5) erkek bulunmaktaydı. Trigliserid ve total kolesterol seviyeleri T2DM hastalarında kontrol grubuna göre anlamlı olarak daha yüksekti (p<0,001). Trigliserid ve total kolesterol seviyeleri ayrıca NPDR ve PDR hastalarında diyabetik retinopatisi olmayan hastalara göre daha yüksekti (p<0,001). C-reaktif proteini, sistemik immün-inflamasyon indeksi, sistemik inflamasyon yanıt indeksi, nötrofil/lenfosit oranı, platelet/lenfosit oranı seviyeleri de T2DM hastalarında daha yüksekti ve bu parametreler PDR'li hastalarda NPDR'li hastalara göre anlamlı şekilde daha yüksekti (p<0,05, tüm karşılaştırmalar için). Sonuç: Sonuç olarak, inflamasyon ve dislipidemi diyabetik retinopati gelişimi, seyri ve tedaviye yanıtında önemli roller oynayabilecek parametreler olabilirler. Takip ve tedavi sırasında bu faktörlerin göz önünde bulundurulması klinik bakımı iyileştirebilir. Tüm bu etkilerin daha iyi gözlemlenebilmesi ve güvenilirliklerinin artırılabilmesi için geniş popülasyonları içeren prospektif çalışmalara ihtiyaç vardır.

Anahtar Kelimeler: Diyabetik retinopati; risk faktörleri; inflamasyon biyobelirteçleri; trigliserid; kolesterol
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