Muhammad Farhan, Umbreen Ahmed, Muhammad Khalid Anwar.
Association of Serum Ferritin and CRP Levels with Development and Severity of Diabetic Retinopathy.
Pak J Physiol Jan ;13(4):11-3.

Background: Diabetes mellitus is a global health issue. Chronic hyperglycaemia induces endothelial dysfunction and metabolic derangements which are postulated to be the cornerstone for the pathogenesis of diabetic microangiopathic complications. The interplay of oxidative stress, endothelial dysfunction and inflammation in this regard has led to investigation of role of inflammatory biomarkers as adjuncts to routine diagnostic testing. This study was designed to elucidate the association between serum ferritin and high sensitivity CRP levels and diabetic retinopathy. Methods: The study was carried out at Department of Physiology and Centre for Research in Experimental and Applied Medicine (CREAM), Army Medical College, in collaboration with Armed Forces Institute of Ophthalmology, Rawalpindi for a period of one year. A total of 90 subjects were recruited into three equal groups; healthy subjects, diabetics and patients with diabetic retinopathy. Serum high sensitivity C-reactive protein (hs-CRP) was estimated by Enzyme Immunoassay (EIA) and serum ferritin levels were carried out by enzyme linked immunosorbent assay. Results: The mean age was 48.50±5.32, 50.90±3.83 and 50.83±3.54 years respectively. Insignificant differences in height, weight and BMI were found across the groups. Highly significant difference was noted in the mean CRP levels in normal subjects. The mean ferritin levels were also found to be significantly different. Univariate multinomial regression revealed that variance in CRP levels could account for 91.1% of variance in status of patients and that in ferritin levels could account for 96.7%. Conclusion: These prognostic markers correlate well with diabetic retinopathy and have an independent predictive ability as well. This may in future be inculcated into screening and surveillance of diabetic microangiopathic complications.

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