Diabetik retinopatide vasküler endotelyal parametrelerin değerlendirilmesi

Diabetes mellitus is a common metabolic disease characterized by, high levels of blood glucose. Microvascular and macrovascular complications are the most important reasons of morbidity and mortality in diabetes mellitus. Diabetic retinopathy is a microvascular complication of diabetes and it is the most common causes of legal blindness in productive ages. In this study, we evaluated the serum levels of intracelluler adhesion molecule-1(ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), E-selectin, P-selectin and endothelin-1 and plasma levels of von willebrand factor (vWF), tissue plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1) and asymmetric dimetyl argininine ADMA which are secreted from vascular endothel, in diabetes and diabetic retinopathy. We aimed to determine the effects of diabetes and diabetic retinoapthy on vascular endothelium and coagulation-fibrinolysis balance.In our study, three groups were formed as follows; Group I: 25 healthy person, Group II: 25 diabetes mellitus patients without retinopathy, Group III: 25 diabetes mellitus patients with retinopathy. 10 ml venous blood samples were collected from all groups, plasma and serum were seperated and centrifuged. Prepared plasma and serum samples were studied with ELISA and results were compared between the groups.E-selectin, P-selectin, VCAM-1, ICAM-1, ADMA, endotelin-1 and vWF levels were found higher in Group 3 to group 1(p:0.045, p:0.014, p:0.034, p:0.038, p:0.000, p:0.021, p:0.007, respectively). E-selectin, ICAM-1, ADMA and vWF levels were found higher in group 2 to group 1 (p:0.018, p:0.014, p:0.002, p:0.004, respectively), there was no significant difference between t-PA, PAI-1, VCAM-1, P-selektin and endotelin-1 levels. In comparison of group 2 to group 3, VACM-1 level was found significantly higher in group 3 (p:0.032), there was no significant difference between other parameters. There was no significant difference between t-PA ve PAI-1 levels all groups (p:0.833, p:0.172, respectively).In conclusion, endothelial damage begins at the early stages of diabetes and increases at further stages. In addition, coagulation-fibrinolysis balance deterioratesin favour of turns to coagulation, in diabetes.Keywords: Diabetic retinopathy, Vascular endothelium, ICAM-1, VCAM-1, E-Selectin, P-Selectin, Endothelin-1, vWF, ADMA, t-PA, PAI-1.