LRG1, kallistatin, VEGF, TGFβ in diabetic retinopathythe relationship of the levels with clinical findings

Purpose: DR is the most common microvascular complication of diabetes. Although there are accused factors in the pathogenesis of the disease, the exact cause is unknown and there is no permanent treatment. New vessel formation with angiogenesis is one of the effective mechanisms in the pathophysiology of the disease. The aim of our study is to examine the relationship between the levels of LRG1, Kallistatin, VEGF, TGFβ, which may be indicators of angiogenesis that have not been studied before in DR, which is a common complication of diabetes, with retinopathy stages. Materials and Methods: 120 people were included in the study, including DR undeveloped 30 diabetic patients, 30 diabetic patients with NPDR, 30 diabetic patients with PDR and control group of 30 healthy volunteers. LRG1, Kallistatin, VEGF, TGFβ levels were measured in the serum of all patients and healthy volunteers participating in the study. The data obtained were analyzed using SPSS 21 package program. Results: There was a difference in LRG1, Kallistatin, VEGF, TGFβ levels between diabetic patients and control group (p=0.001). LRG1 mean was 470.22 ± 18.92 ng/ml in the PDR group, 438.74 ± 33.5 ng / ml in the NPDR group, 408.9 ± 39.44 ng / ml in the Non-DR diabetics and 359,9 ± 89.78 ng/ml in the control group. LRG1 levels were highest in the PDR group and lowest in the control group. In subgroup analysis, there was a difference between LRG1 levels; between PDRNPDR (p=0.001), between PDR-Non DR diabetics (p=0.001), between PDR-Control (p=0.001), between NPDR-Control (p=0.001), NPDR-Non DR diabetics (p=0.002). Kallistatin mean was 608.64 ± 352.45 ng/ml in the PDR group, 272.21 ± 240.13 ng/ml in the NPDR group, 284.4 ± 222.63 ng/ml in the Non-DR diabetics, and 186,0 ± 217,71 ng/ml in the control group. There was a difference in kallistatin levels between PDR group and control, Non-DR diabetics and NPDR groups (p=0.001). VEGF mean was 378,54±163,63 pg/ml in PDR group, 247,43±95,62 pg/ml in NPDR group, 252,7±80,06 pg/ml in Non-DR diabetics and 204,4±79.83 pg/ml in control group. In the PDR group, VEGF value was higher than all other groups: PDR- Non DR p=0.003, PDR-NPDR p=0.003, PDR-Control p=0.001. Mean TGFß was 35.28 ± 14,9 ng/ml in PDR group, 28.84 ± 5,7 ng/ml in NPDR group, 24.66 ± 9,69 ng/ml in Non-DR diabetics and 22.24 ± 5,4 ng/ml in control group. TGFß levels were significantly higher in the PDR group than in the Non-DR diabetics and control group (p=0.012, p=0.001). There was also a difference between NPDR-control group (p=0.001). Conclusion: Biomarkers thought to play a role in angiogenesis; LRG1, Kallistatin, VEGF, TGFβ; An increase in plasma levels was observed in PDR. These markers can be used as non-invasive and cheap markers in early diagnosis and staging of DR. Key words: DR, PDR, LRG1, Kallistatin, VEGF, TGFβ