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Role of intereleukin-6 in the visual impairment of diabetic patients

Session Poster session 4

Speaker Evangelos Oikonomou

Event : ESC Congress 2015

  • Topic : preventive cardiology
  • Sub-topic : Metabolic Syndrome, Insulin, Insulin Resistance
  • Session type : Poster Session

Authors : N Gouliopoulos (Athens,GR), G Siasos (Athens,GR), M Moschos (Athens,GR), E Oikonomou (Athens,GR), G Siasou (Athens,GR), T Paraskevopoulos (Athens,GR), T Konsola (Athens,GR), M Zaromytidou (Athens,GR), E Dimitropoulos (Athens,GR), D Tousoulis (Athens,GR)

N. Gouliopoulos1 , G. Siasos1 , M. Moschos2 , E. Oikonomou1 , G. Siasou1 , T. Paraskevopoulos2 , T. Konsola1 , M. Zaromytidou1 , E. Dimitropoulos1 , D. Tousoulis1 , 1University of Athens Medical School, 1st Cardiology Department, “Hippokration” Hospital - Athens - Greece , 2University of Athens Medical School, Department of Ophthalmology - Athens - Greece ,

European Heart Journal ( 2015 ) 36 ( Abstract Supplement ), 642-643

Background: Diabetic Retinopathy (DR) is a complication of diabetes mellitus leading to deterioration of vision. Inflammatory cytokines are key players in the pathophysiology of atherosclerotic disease.

Purpose: To investigate the association of inflammatory status with visual acuity in subjects with diabetes mellitus.

Methods: We enrolled 100 consecutive subjects with diabetes mellitus. Patients were divided in those with DR (53 subjects, mean age 68±9) and those with no evidence of DR (NDR) (mean age 66±6). The diagnosis of DR was made by ophthalmoscopy and best-corrected visual acuity (BCVA) was measured in both eyes. A BCVA less than 0.8 was considered as severely impaired. C reactive protein (CRP) and Intereleukin-6 (IL-6) were measured as well established inflammatory markers contributing to atherosclerosis progression.

Results: Although there were no significant differences in baseline characteristics, patients with DR compared to NDR patients had increased levels of Il-6 [2.24 (1.33–3.99)pg/ml vs. 1.51 (0.96–3.05)pg/ml, p=0.03] and worse BCVA [0.8 (0.92–1) vs. 0.8 (0.5–1), p<0.001], while there was no significant difference in CRP levels [2.85 (0.91–4.41)mg/L vs. 1.25 (0.56–4.29)mg/L, p=0.12]. Moreover, in diabetes mellitus subjects, BCVA was inversely correlated with IL-6 levels (r=−0.25, p=0.03), CRP levels (r=−0.26, p=0.16) glycosylated hemoglobin levels (r=−0.38, p<0.001), age (r=−0.34, p=0.001) and with duration of diabetes mellitus (r=−0.41, p<0.001) and positively correlated with creatinine clearance (r=0.21, p=0.04). Interestingly, after adjustment for age, gender, body mass index, smoking habits, CRP levels, insulin treatment and the aforementioned confounders, IL-6 was independently associated with BCVA [b=−0.034 95% CI (−0.056, −0.012), p=0.004] while CRP was not a significant factor in the multivariate model. Moreover, ROC curve analysis revealed that IL-6 levels (AUC=0.70, p=0.01) have a significant diagnostic ability in detecting diabetic subjects with severely impaired BCVA. More precisely, IL-6 levels more than 1.85pg/ml has a sensitivity of 78% and a specificity of 65%, for the diagnosis of severely impaired BCVA.

Conclusion: Patients with DR have significantly impaired visual acuity which is associated with systemic inflammatory status. These findings highlight the significant role of inflammation in the progression of diabetic complications and provide therapeutic implications which merit further study.

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