title: Systemic soluble tumor necrosis factor receptors 1 and 2 are associated with severity of diabetic retinopathy in Hispanics.
abstract: OBJECTIVE
  To investigate the associations of serum amyloid A (SAA) protein and soluble tumor necrosis factor receptors 1 and 2 (sTNF-R1 and sTNF-R2) with diabetic retinopathy (DR) in Hispanics.
  
  
  METHODS
  Prospective, nonrandomized, cross-sectional, family-based observational cohort study.
  
  
  METHODS
  A total of 473 Hispanic type II diabetic subjects in families ascertained via proband with DR.
  
  
  METHODS
  Levels of SAA, sTNF-R1, and sTNF-R2 were measured with enzyme-linked immunosorbent assay. Diabetic retinopathy was assessed by fundus photography and graded using modified Airlie House classification.
  
  
  METHODS
  Levels of SAA, sTNF-R1, and sTNF-R2 to severity of DR with and without covariates.
  
  
  RESULTS
  A direct association of sTNF-R1 (2.37±0.13, 2.15±0.09, 3.09±0.24, 3.25±0.46, 5.02±0.61 ng/ml; P < 0.0001) and sTNF-R2 (6.04±0.20, 6.25±0.52, 7.96±0.70, 8.14±1.13, 14.83±1.68 ng/ml; P < 0.0001) was found for no DR, mild nonproliferative DR (NPDR), moderate NPDR, severe NPDR, and proliferative DR, respectively. These associations remained significant after adjusting for age, gender, body mass index, glycosylated hemoglobin, diabetes duration, systolic blood pressure, and serum creatinine (P < 0.0001 for sTNF-R1 and P=0.0004 for sTNF-R2). A similar pattern was observed when we adjusted for urinary albumin:creatinine ratio in place of serum creatinine (P=0.005 for sTNF-R1 and P=0.02 for sTNF-R2).
  
  
  CONCLUSIONS
  Levels of sTNF-R1 and sTNF-R2 are highly correlated with the severity of DR, suggesting that inflammation and insulin resistance may play a critical role in the development of DR. These may be useful biomarkers for DR, aiding in etiologic studies and possibly identifying at-risk patients for active intervention.
authors.affiliation: Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Jane Z
authors.initials: JZ
authors.lastname: Kuo
authors.forename: Xiuqing
authors.initials: X
authors.lastname: Guo
authors.forename: Ronald
authors.initials: R
authors.lastname: Klein
authors.forename: Barbara E
authors.initials: BE
authors.lastname: Klein
authors.forename: Jinrui
authors.initials: J
authors.lastname: Cui
authors.forename: Jerome I
authors.initials: JI
authors.lastname: Rotter
authors.forename: Eli
authors.initials: E
authors.lastname: Ipp
authors.forename: Yii-Der Ida
authors.initials: YD
authors.lastname: Chen
mesh_terms: D001794:Blood Pressure; D015331:Cohort Studies; D003401:Creatine / Q000097:blood; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology / Q000503:physiopathology; D003930:Diabetic Retinopathy / Q000208:ethnology / Q000503:physiopathology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D047888:Receptors, Tumor Necrosis Factor, Type I / Q000097:blood*; D047889:Receptors, Tumor Necrosis Factor, Type II / Q000097:blood*; D012307:Risk Factors; D000685:Serum Amyloid A Protein / Q000378:metabolism; D012720:Severity of Illness Index
chemical_list: D047888:Receptors, Tumor Necrosis Factor, Type I; D047889:Receptors, Tumor Necrosis Factor, Type II; D000685:Serum Amyloid A Protein; D003401:Creatine