Serum amyloid A, C-reactive protein, and retinal microvascular changes in hypertensive diabetic and nondiabetic individuals: an Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) substudy.
OBJECTIVE
To study the association of the inflammatory markers serum amyloid A (SAA) and C-reactive protein (CRP) with retinal microvascular parameters in hypertensive individuals with and without type 2 diabetes.


METHODS
This cross-sectional analysis was a substudy in 711 patients (159 with and 552 without diabetes) of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) based on digital 30-degree images of superior and inferior temporal retinal fields.


RESULTS
SAA was associated with arteriolar length-to-diameter ratio positively in nondiabetic patients (P(trend)= 0.028) but negatively in diabetic patients (P(trend)= 0.005). The difference was unlikely to be a chance finding (P = 0.007 for interaction). Similar results were found for the association of SAA with arteriolar tortuosity (P = 0.05 for interaction). Associations were less pronounced for CRP and retinal parameters.


CONCLUSIONS
Inflammatory processes are differentially involved in retinal microvascular disease in diabetic compared with nondiabetic hypertensive individuals.
Stettler
Christoph
C
Division of Endocrinology, Diabetes and Clinical Nutrition, University Hospital and University of Bern, Bern, Switzerland. christoph.stettler@insel.ch
Witt
Nicholas
N
Tapp
Robyn J
RJ
Thom
Simon
S
Allemann
Sabin
S
Tillin
Therese
T
Stanton
Alice
A
O'Brien
Eoin
E
Poulter
Neil
N
Gallimore
J Ruth
JR
Hughes
Alun D
AD
Chaturvedi
Nish
N
D002097:C-Reactive Protein / Q000378:metabolism*; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000453:epidemiology / Q000473:pathology*; D005060:Europe / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology / Q000473:pathology*; D008833:Microcirculation / Q000502:physiology; D012171:Retinal Vessels / Q000473:pathology*; D000685:Serum Amyloid A Protein / Q000032:analysis*; D006113:United Kingdom / Q000453:epidemiology
D000685:Serum Amyloid A Protein; D002097:C-Reactive Protein