Analysis of the diagnostic value of plasma endothelin for diabetic retinopathy using the receiver operating characteristic curve.
OBJECTIVE
To investigate the diagnostic efficacy and clinical application value of plasma endothelin-1 for diabetic retinopathy using receiver operating characteristic (ROC) curve analysis.


METHODS
This was a prospective investigational study. Funduscopy and fundus fluorescein angiography were used as gold standards for the diagnosis of diabetic retinopathy. Plasma endothelin-1 was measured in 96 diabetic patients with retinopathy (the case group) and 144 diabetic patients without retinopathy (the control group). Enumerative data were listed in a fourfold table. The measurement data were analyzed by Student's t test and evaluated by cross-table analysis and ROC curve analysis.


RESULTS
(1) The plasma endothelin-1 concentration was higher in the case group than the control group (p = 0.002 < 0.01). (2) If the plasma endothelin-1 level of 162 pg/ml was adopted as the threshold for clinical diagnosis of diabetic retinopathy, the diagnostic sensitivity was 71.2%, diagnostic specificity 58% and diagnostic accuracy 66%. The positive predictive value was 69.81% and the negative predictive value 59.46%, and the positive likelihood ratio was 1.69 and the negative likelihood ratio 0.50. (3) When plasma endothelin-1 was used as a diagnostic criterion for diabetic retinopathy, the area under the ROC curve was 0.737.


CONCLUSIONS
Plasma endothelin-1 plays an important role in the development and progression of diabetic retinopathy. When 162 pg/ml of plasma endothelin-1 was adopted as the diagnostic threshold, the diagnostic accuracy was medium; hence, the plasma endothelin-1 level can be used as the first step for diabetic retinopathy screening.
Zhu
Hong
H
Department of Ophthalmology, No. 3 People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Shi
Cai-Hong
CH
D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D003930:Diabetic Retinopathy / Q000097:blood* / Q000175:diagnosis*; D019332:Endothelin-1 / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve
D019332:Endothelin-1