title: C-reactive protein, body mass index, and diabetic retinopathy.
abstract: OBJECTIVE
  C-reactive protein (CRP) is an inflammatory biomarker that may be associated with diabetic retinopathy (DR), but body mass index (BMI) is an important confounder of this relationship. The purpose of this study was to determine the relationship between CRP, BMI, and existing DR.
  
  
  METHODS
  This was a population-based, cross-sectional study on 718 persons with diabetes in the Singapore Malay Eye Study (SiMES). Diabetes was defined as random glucose>or=11.1 mmol/L, on diabetic medication or a history of physician-diagnosed diabetes. CRP was measured in frozen plasma. DR was graded from retinal photographs.
  
  
  RESULTS
  Higher CRP and BMI were associated with lower prevalence of DR. After adjustment for age, sex, HbA1c level, hypertension, smoking, total cholesterol level, cholesterol-lowering medication, and insulin use, persons with the highest quartiles of CRP were less likely to have any DR (odds ratio [OR] 0.5; 95% CI, 0.3-0.9, comparing the fourth with the first quartile of CRP), vision-threatening DR (OR 0.3; 95% CI, 0.1-0.7), or CSME (OR 0.2; 95% CI, 0.1-0.6). Similarly, persons with the highest quartiles of BMI were less likely to have any DR (OR 0.5; 95% CI, 0.3-0.7), moderate DR (OR 0.4; 95% CI, 0.2-0.7), vision-threatening DR (OR 0.4; 95% CI, 0.1-0.8) or CSME (OR 0.2; 95% CI, 0.0-1.0). No significant interactions between CRP and BMI on DR were seen.
  
  
  CONCLUSIONS
  Persons with diabetes who had higher levels of CRP and BMI were less likely to have DR. Further research is needed to understand the interrelationship role of inflammation, body weight, and microvascular complications.
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore;
authors.forename: Laurence Shen
authors.initials: LS
authors.lastname: Lim
authors.forename: E Shyong
authors.initials: ES
authors.lastname: Tai
authors.forename: Paul
authors.initials: P
authors.lastname: Mitchell
authors.forename: Jie Jin
authors.initials: JJ
authors.lastname: Wang
authors.forename: Wan Ting
authors.initials: WT
authors.lastname: Tay
authors.forename: Ecosse
authors.initials: E
authors.lastname: Lamoureux
authors.forename: Tien Yin
authors.initials: TY
authors.lastname: Wong
mesh_terms: D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data*; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism*; D003430:Cross-Sectional Studies; D003930:Diabetic Retinopathy / Q000208:ethnology* / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index; D012846:Singapore / Q000453:epidemiology
chemical_list: D002097:C-Reactive Protein