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Article Type

Original Study

Abstract

Objectives The objective of this study was to assess the usefulness of relative quantification of endothelin-1 (ET-1) in peripheral blood mononuclear cells in diabetic retinopathy (DR). Background DR is one of the most serious complications of diabetes mellitus (DM) that can lead to blindness. Alterations in activity of the ET system are believed to underlie the development of chronic complications of type 2 diabetes mellitus (T2DM). Patients and methods This is a clinical study carried out at Medical Biochemistry and Ophthalmology Departments. It included 50 patients divided into three groups: group I (included 14 diabetics without DR), group II (included 26 diabetics with DR), and group III (included 10 normal healthy controls). All studied patients were subjected to full history taking, clinical and ophthalmological examination, and laboratory investigations including fasting blood glucose, glycated hemoglobin (HbA1c), lipid profile, serum creatinine, urinary albumin, and creatinine and ET-1 mRNA level in peripheral blood mononuclear cells using real-time quantitative reverse transcription PCR. Results The mRNA level of ET-1 was significantly higher in diabetics with DR than those without retinopathy and was higher in diabetics than in controls. In diabetics with DR, the blood mRNA level of ET-1 was significantly higher in patients with proliferative diabetic retinopathy than in those with nonproliferative diabetic retinopathy. Increased expression of ET-1 mRNA was associated with severity of DR, duration of DM, insulin therapy, and serum creatinine level. Decreased expression of ET-1 mRNA was associated with sulfonylureas treatment. Expression of ET-1 mRNA was not affected by age, sex, BMI, smoking, and control of blood sugar. Conclusion Expression of ET-1 is associated with severity of DR in T2DM. Expression of ET-1 is positively correlated with duration of DM, serum creatinine, and urinary albumin. A larger study is needed to confirm the role of ET-1 mRNA determination in the progression of retinal changes in patients with T2DM.

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