INSULIN DEPENDENT DIABETES MELLITUS

CORRELATION BETWEEN SIALIC ACID AND DIABETIC RETINOPATHY

Abstract

A i m s & O b j e c t i v e s : To test the hypothesis that an increased plasma concentration of sialic acid, a marker of the acutephase
response, is related to the presence of diabetic retinopathy in type 1 diabetes mellitus or Insulin Dependant Diabetes Mellitus (IDDM).
R e s e a r c h D e s i g n a n d M e t h o d s : We investigated the relationship between plasma sialic acid concentration and diabetic retinopathy in a
cross-sectional survey of 1,369 people with type 1 diabetes. Subjects were participants in the IDDM Complications Study, which involved
diabetic centers of four different hospitals in Lahore. Results: There was a significantly increasing trend of plasma sialic acid with severity
of retinopathy (P < 0.001 in men) and with degree of urinary albumin excretion (P < 0.001 men, P < 0.01 women). Elevated plasma sialic
acid concentrations were also associated with several risk factors for diabetic vascular disease: diabetes duration, HbAlc, plasma triglyceride
and cholesterol concentrations, waist-to-hip ratio, hypertension and smoking (in men), and low physical exercise (in women). In multiple
logistic regression analysis, plasma sialic acid was independently related to proliferative retinopathy and urinary albumin excretion rate in
men. Conclusions: We concluded that an elevated plasma sialic concentration is strongly related to the presence of microvascular
complications in type 1 diabetes with retinopathy and nephropathy. Further study of acute-phase response markers and mediators as
indicators or predictors of diabetic microvascular complications is therefore justified.