title: C-reactive protein and diabetic retinopathy in Chinese patients with type 2 diabetes mellitus.
abstract: OBJECTIVE
  To investigate the relationship between C-reactive protein (CRP) and diabetic retinopathy (DR) in a cohort of Chinese patients with type 2 diabetes mellitus (T2DM).
  
  
  METHODS
  Community-based observational cohort study. There were 1131 participants recruited from November 2009 to September 2011 in Desheng community in urban Beijing. Patients diagnosed T2DM were recruited and underwent a standardized evaluation consisting of a questionnaire, ocular and anthropometric examinations and laboratory investigation. The presence and severity of DR were assessed by seven fields 30° color fundus photographs. Subjects were then classified into groups with no DR, any DR, or vision-threatening DR. CRP was analyzed from serum of study subjects.
  
  
  RESULTS
  A total of 1007 patients with T2DM were included for analysis, including 408 (40.5%) men and 599 (59.5%) women. The median CRP level was 1.5 mg/L for women and 1.1 mg/L for men (P=0.004, OR 0.37, 95% CI 0.18-0.74). After adjusting for possible covariates, higher levels of CRP were associated with lower prevalence of any DR (P=0.02, OR 0.55, 95% CI 0.35-0.89), but not associated with vision-threatening DR (P=0.62, OR 0.78, 95% CI 0.28-2.14). After stratification by sex, the inverse association between CRP and DR was found to be statistically significant in men (P=0.006, OR 0.35, 95% CI 0.16-0.73), but not in women (P=0.58, OR 0.88, 95% CI 0.29-1.16).
  
  
  CONCLUSIONS
  The data drawn from a Chinese population with T2DM suggest that increasing CRP levels may be inversely associated with development of DR.
authors.affiliation: Department of Ophthalmology, the Friendship Hospital, Capital Medical University, Beijing 100050, China; Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
authors.forename: Xiu-Fen
authors.initials: XF
authors.lastname: Yang
authors.affiliation: Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Deng
authors.affiliation: Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Gu
authors.affiliation: Department of Mathematics and Computer Science, Faculty of Science and Technology, Prince of Songkla University, Pattani Campus, Muang Pattani 9400, Thailand.
authors.forename: Apiradee
authors.initials: A
authors.lastname: Lim
authors.affiliation: Sekwa Research Institute, Beijing 100088, China.
authors.forename: Torkel
authors.initials: T
authors.lastname: Snellingen
authors.affiliation: Sekwa Research Institute, Beijing 100088, China.
authors.forename: Xi-Pu
authors.initials: XP
authors.lastname: Liu
authors.affiliation: Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
authors.forename: Ning-Li
authors.initials: NL
authors.lastname: Wang
authors.affiliation: Fundus Photograph Reading Center, Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison 53705, Wisconsin, USA.
authors.forename: Amitha
authors.initials: A
authors.lastname: Domalpally
authors.affiliation: Fundus Photograph Reading Center, Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison 53705, Wisconsin, USA.
authors.forename: Ronald
authors.initials: R
authors.lastname: Danis
authors.affiliation: Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
authors.forename: Ning-Pu
authors.initials: NP
authors.lastname: Liu
keywords: C-reactive protein; diabetic retinopathy; inflammation; type 2 diabetes mellitus