INSULIN DEPENDENT DIABETES MELLITUS

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 acutephaseresponse, 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 across-sectional survey of 1,369 people with type 1 diabetes. Subjects were participants in the IDDM Complications Study, which involveddiabetic centers of four different hospitals in Lahore. Results: There was a significantly increasing trend of plasma sialic acid with severityof retinopathy (P < 0.001 in men) and with degree of urinary albumin excretion (P < 0.001 men, P < 0.01 women). Elevated plasma sialicacid concentrations were also associated with several risk factors for diabetic vascular disease: diabetes duration, HbAlc, plasma triglycerideand cholesterol concentrations, waist-to-hip ratio, hypertension and smoking (in men), and low physical exercise (in women). In multiplelogistic regression analysis, plasma sialic acid was independently related to proliferative retinopathy and urinary albumin excretion rate inmen. Conclusions: We concluded that an elevated plasma sialic concentration is strongly related to the presence of microvascularcomplications in type 1 diabetes with retinopathy and nephropathy. Further study of acute-phase response markers and mediators asindicators or predictors of diabetic microvascular complications is therefore justified.