The Relevance of a Significant Correlation between ET-1 and Clinical Markers Such as Microalbuminuria and Fundus Oculi Changes in Early Detection of Diabetic Nephropathy in Type 2 Diabetes
Prolonged hyperglycemia and insulinre-sistance in type II diabetes are the main factors contributing to the damage of the vascular endothelium (endothelial dysfunction) leading to micro and macroangiopathy which result in significant amounts of damage towards many internal organs such as cardiovascular diseases, diabetic retinopathy (DR) and nefropathy (DN). Those pathologies frequently result life threatening for the patient. The employment of high-sensitivity biomarkers for the early detection endothelial dysfunction in general and more specifically for the renal endothelial dysfunction seems to represent a major step ahead towards an improvement in the management algorithms of diabetes and its severe complications. Purpose The aim of our study is to discover the correlations of endothelin-1 (ET1) with known clinical markers of endothelial dysfunction such as microalbuminuria (MA) and fundus oculi (FO) findings in order to help an early detection of renal damage and consequently preventing or slowing progress of diabetic nephropathy (DN). Materials and methods: This is a prospective study where some eighty type 2 diabetes patients were recruited and were dichotomized in 2 groups. In the first group were included forty patients with normoalbuminuria (urinary albumin 0-30 mg/24 hours) while in the second were included the remaining forty patients with microalbuminuria (urinary albumin 30-300 mg/24 hours). Plasma ET-1 levels and 24 hour urinary excretion of albumin were measured. Diabetic retinopathy assessment was made according to the International Clinical Diabetic Retinopathy Disease Severity Scale which includes 5 severity scales. The first scale without retinopathy, the second of light retinopathy non proliferative, the third of moderate non proliferative and the fourth severe retinopathy non proliferative and the fifth one of proliferative retinopathy. Results: We found a statistically significant correlation between ET-1 and MA (p<0.001) and ET-1 with fundus
